medicine, sociology of

A field of sociology that focuses on medicine as a set of ideas and practices. However, exact delineation of the field is problematic. In the first place, there is disquiet about identifying a field of sociology in terms of its relation to another profession. This issue has often been raised by drawing a contrast between sociology in medicine and the sociology of medicine. Sociology in medicine, it is argued, works within the constraints and parameters of medicine, accepting its objectives and priorities. Sociology of medicine adopts a more detached, critical approach, in which the sociological enterprise has priority over the medical. According to this argument, the sociology of medicine is consequently a legitimate field of sociology, whereas sociology in medicine is not. However in both cases the field is still defined in relation to medicine. Other writers prefer a broader designation of the territory, such as the sociology of healing or of healers, or the sociology of health-care systems, in order to make it clear that doctors are not the only group involved in healing or the only components of the health-care system. There are a range of health carers such as nurses and physiotherapists, as well as informal carers, whose work needs to be examined and should not be subsumed under the umbrella of medicine. A further problem with the delineation of the field concerns the relation of the sociology of medicine to the sociology of health and illness . Many would argue that the sociology of medicine necessarily embraces the sociological study of health and illness, since these are the core of medicine's concern; others would argue that the focus should be rather narrower and concentrate on medicine as a profession , and that the sociology of health and illness should be treated as a separate field of study.

Notwithstanding these territorial difficulties, the sociology of medicine, broadly defined, has flourished since the 1950s. Although its roots lie in part in the social medicine of the inter-war years and earlier, its sociological impetus came primarily from Talcott Parsons's influential work on the medical profession and the sick role , which put medicine and illness into the mainstream of sociology.

Leaving aside the questions concerning health and illness, the sociology of medicine in its narrower definition focuses on two major issues. A first and dominant concern is to analyse the nature, extent, and origins of the power of the medical profession, and the relation of the medical profession to other allied professions. The work of Eliot Freidson in The Profession of Medicine (1971), with his emphasis on autonomy as the defining feature of a profession, exemplifies this tradition. It has been further developed by a number of feminist writers, such as Ann Oakley, who have examined the exclusionary tactics deployed by the medical profession in the medicalization (a term particularly associated with Ivan Illich's study Medical Nemesis, 1976) of events such as childbirth-a medicalization that not only excludes the female midwife but also increases the powerlessness of women who are giving birth.

Doctor-patient relationships constitute the second major focus of the sociology of medicine, with work ranging from in-depth studies of doctor-patient interactions, including analyses of tape-recorded doctor-patient exchanges, to large-scale surveys of doctor-patient satisfaction, the time spent with patients, and so forth. The care of the dying has received especial attention, as has the socialization of medical students. Ruth Laub Coser's Life in the Ward (1962) illustrates this tradition.

However, whilst these two areas will no doubt remain at the core of the sociology of medicine, it seems likely that the activities of the medical profession will be increasingly located within the context of the study of other health workers and the wider health-care system (see, Ideas about Illness: An Intellectual and Political History of Medical Sociology, 1989). 's Medical Sociology (1983) is one of the many textbooks dealing with this specialism.