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Sociology in medicine, in its most extreme form, encompasses work aimed at the provision of technical skills and problem solving for the medical community while neglecting contributions to the parent discipline. Medical sociology experienced dual roles early in its institutionalization. Sociology in medicine and sociology of medicine were the names designated for applied and pure work, respectively, by Robert Straus in 1957. Sociology in medicine represents the thrust toward reform, advocacy, and application. During the 1950s and 1960s, the primary aim of medical sociology was to serve medicine, with a large majority of medical sociologists employed by health science, and only 30 percent holding appointments in traditional sociology departments. This ascendancy was short lived as the effects of the cold war, which equated sociology with socialism, decreased the influence of sociology on public health issues and policy. Through increasing opportunities during the 1980s, sociology in medicine again became an exciting career choice for medical sociologists.
The work of sociologists in medicine is directly applicable to health issues, focusing on disease processes or factors influencing patients’ responses to illness, with goals of improving diagnosis and treatment. It may examine doctor-patient relationships, various therapeutic situations, or social factors that affect and are affected by specific health disorders. The sociologist in medicine may also have responsibilities of educating health science students in sociology of health and illness. The major contributions of sociology in medicine have been to medical education, social epidemiology, and knowledge of utilization and compliance. Sociologists in medicine seek to answer questions of interest to their sponsors and institutions rather than to the discipline of sociology.
Sociology in medicine, then, treats sociology as a supporting discipline to medicine, which involves achieving the goals of medicine. For this reason, sociology in medicine has been severely criticized since its inception. Sociologists in medicine are less compelled to defend the significance of their work to the academic community than are conventional sociologists. The demands placed upon the sociologist in medicine are for practical applications rather than sociological significance. Therefore, sociology in medicine has consistently battled with the question of whether or not it is real sociology. Aside from criticisms of its parent discipline, sociology in medicine has historically faced problems within its working environment as well. Communication, status, and relationship issues have surrounded it since the first tenure-track position was created for a sociologist in a medical school in 1953.
When the distinction was made between pure and applied work of medical sociologists, the predominant opinion of sociologists was that the two were incompatible. Academic sociologists believed sociologists in medicine showed loyalty to the medical institution and did not contribute to the discipline. Those working in medicine considered themselves to be quite practical sociologists, as their work was directly applicable to human health. The opinion of incompatibility has changed dramatically and will continue to change. Straus, who named the distinction in 1957, wrote in 1999 that it is possible for the medical sociologist to do both pure and applied work. Many current medical sociologists consider the structural position of the scholar to be irrelevant today, and have called for a re-naming of the work of medical sociologists. Rather than distinguishing between sociology in medicine and sociology of medicine, work of medical sociologists may be aptly called sociology with medicine.
References:
- Straus, R. (1957) The nature and status of medical sociology. American Sociological Review 22: 200-4.
- Straus, R. (1999) Medical sociology: a personal fifty year perspective. Journal of Health and Social Behavior 40: 103-10.
- Cockerham, W. C. (2007) Medical Sociology, 10th edn. Prentice Hall, Englewood Cliffs, NJ.
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