Sociology of Medicine and Health Lecture 15

Sociology of Medicine and Health ? Class 15 - Physicians Public gives physicians a ?labor market shelter? ? they are not subjected to the same accountability as other occupations In return for assumed high quality care, doctors are given a monopoly over medicine Doctors are not ?held accountable? for the results of their work Social Profile Physicians tend to be urban, white, male, upper-middle class But that is changing, now around 50/50 male female in med school, and more diverse High Status Prestige occupation, parents tend to be also high status High Income Average salary for doctors Highest is radiation oncology based on Gross salary ? high tech specialty Lowest is family medicine ? low tech specialty Data from NY Times Note: Physicians have expenses like mall practices, insurances, staff and office expenses that are not reflected in these data Medical Training Competitive entry into medical school 1/9 get accepted Favor science based backgrounds Formal Education First 2 years science courses and than rotations ? more work hours Informal Socialization Beginning of medical school Value of altruism, serving people End of post graduate training (residency) 3-7 years training Values of professionalism Specialty choice Male specialty ? high tech Female specialty ? low tech Other correlations 24 American Medical Association (AMA) Each specialty board certifies doctors who pass an exam Specialty boards help doctor control medicine Strong influence on medical education Some influences on practice Doctors view problems based on their specialties Group Practice Majority of doctors now salaries employees of a group practice ? in the past they used to own their own practice Group practiced differs enormously Small ? 3 to 4 doctors Large - HMO ? advantage, work less, more resources to get supplies (ie. more money) However must adjust to other people and you have boss Satisfactions and dissatisfaction Most doctors very satisfied with life and job Many doctors worry about government and manage care regulations of practice ? insurance companies Heavy patients load can contribute to dissatisfaction Political attitudes of physicians Doctors are more conservative than general public (more property) But diversity among doctors and their attitudes is increasing AMA traditional very conservative Membership in AMA has decreased because too conservative for younger physicians Orientation of physicians toward patients Technicians Used of impersonal jaron? to describe patient Belief in special stratus of doctors? Moderns ? however physician, more use of technology Counselors ? older physicians, does not keep up with new technology, grandfather type Less energy Really like patient contact Withdrawals Do not like contact/people Do not like new technology/theories Do not like their job