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A whistlestop tour through medical sociology

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Caroline Tomes

on 1 September 2014

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Transcript of A whistlestop tour through medical sociology

Thank You!
Why might sociology be important
for public health?
Session Objectives
Revise key concepts
Stigma (Goffman, 1963)
Attribute that is deeply discrediting within a particular social interaction
Illness as
Medical sociology:

A whistlestop tour for public health registrars
"From its original purpose as the ´science of society´, sociology has moved on...to understand how society works. It seeks to provide insights into the many forms of relationship, both formal and informal, between people. Such relationships are considered to be the ´fabric´ of society. "
British Sociological Association
Identify public health examples of concepts
Parson's sick role
Doctor patient relationships
Impairment, disability, handicap
Dissect some past exam questions
The sick role (Parson,1951)
Two rights...
Two responsibilities
Exempt from normal social roles

Not responsible for their condition
To want to get better

To seek help and cooperate with medical advice
Can you think of examples why / where this theory works?
...And doesn't work?
Doctor-Patient relationships
Patient control
Doctor Control
Passive patient & lacks direction
Traditional D-P relationship
Guidance leads to cooperation
Dr as 'parent'
Traditional roles are reversed
Active patient, passive doctor
e.g. Private healthcare
Patients as equal partners
Both contribute
Relationship is essential to effective healthcare practice
Interactions inform consultation outcomes
The theory doesn't always work...
Illness doesn't always mean exemption...
Not all problems
can be cured...
Some patients may lack insight...
Things which influence the relationship between Doctors and patients
EBM v. Targets
Perception of
Dr role and relationship
Secondary deviance
any general deviance
before the deviant is
labeled as such.

e.g. symptoms (seizure, mood swings) but no diagnosis or change in self-concept
any action that takes
place after primary deviance as a reaction to the institutions.

e.g. change in self-concept following diagnosis (epileptic, person with depression)

Labeling influences social reactions

Caroline Tomes
BA (Hons) MSc MPhil MFPH

June 2014


Why is stigma important?
What can we do to tackle stigma?
...can be felt or enacted
Risk communication
criminal or health issue?
Major cause of morbidity and mortality, esp. in developed countries
Different perspectives
Individual issue?
Society issue?
e.g. activities of daily living scale
e.g. DDA, EPP
Social Model of Disability

Society disables those with physical impairments via a range of

Adopted by WHO
Disability Rights Commission recognise & address environmental and cultural bariers
(Illich, 1975)
Clinical Iatrogenesis
Treatment makes things worse / creates new illness
Social Iatrogensis
Medicine invades 'normal' life
Creates new healthcare demands
Structural Iatrogensis
Increased reliance on medicine leading to loss of traditional coping mechanisms
MFPH Part A - Exam Tips
State why the topic is important to public health

Everyday examples to illustrate theories

Start practicing writing early

Get to know the past papers

Ask for help if needed
Jan 2002 Q7

Identify the possible impact of a primary psychiatric diagnosis of a behavioural disorder on a child in relation to theories of primary and secondary deviance.

June 2009 Q8

Write short notes on each of the following, commenting on their implications for public health:

a) the clinical iceberg (33% of marks)
b) non-verbal communication (33% of marks)
c) stigma (33% of marks)

Jan 2007 Q8

What factors make people more or less likely to follow advice from health professionals to change their health-related behaviour?

Illustrate your answer with reference to one or more sociological theories.
Full transcript