Hierarchy and power are intrinsic to the Australian health system as the position which one belongs to in the society determine the quality of the healthcare services that one will get. It has been seen that the social actors who belong to the lowest band in the hierarchy have to scavenge often to get the best quality of healthcare services (Scambler, 2013). On the other hand, the powerful or the affluent seem to get the best quality of medical services and a clear power play can be noticed. The widely followed biomedical model refuses to recognize any other facets of illness and health as it solely focuses on the Biological aspects of health (Henslin, et al. 2015). On the other hand, it has been seen through decades that there are certain if not all, types of diseases that do have a strong socio-economic or socio cultural background. The following paragraphs will discuss in depth the power and hierarchy that lies in the heart of the Australian healthcare system. It will also discuss the key concepts and the dimensions of healthcare with appropriate theoretical underpinnings.
The study of the relationship between the individual and the society is known as Sociology. This particular branch of study is concerned with how each social actor in a society is affected by each other’s actions and how different institutions influence the actions of individual social actors. Medical Sociology helps us decipher the many ways in which cultural and social conditions affect health, medical practices and illness. Medical Sociology presents an alternative view to the medical sector which vies illness in the light of bio medical model. Sociology comes handy in order to prevent medicalization, a concept where health professionals force the concept of medicines on a large portion of the society without having adequate knowledge of the depth and the epistemology of a health problem.
The bio medical model focuses completely on the biological aspects of illness and diseases. It encourages to treat an illness based on the symptoms that may be visible on an ailing patient. The model focuses on individuals and restores their health so as to return him or her to the pre-illness state, where there would be a lack of disease. The model generally excludes the social and behavioural aspects of health. The biomedical model certainly has some advantages in the fact that it encourages advances in technology as it moves science in the direction of discoveries to treat the ill and the unhealthy. It also extends life expectancy as it prevents diseases and other ailments as well as promoting a better quality of life by constantly promoting a healthy body and mind. The biomedical model comes with some limitations also. It is expensive as it involves technologies and healthcare professionals who are highly trained. Besides, the quick fix aspect of the bio medical model often promotes a superficial fix and fails to prevent or to ensure the demise of any disease. On the other hand, the social model of health deals with the broader aspects of health that takes into consideration economic, environmental, social and cultural facets of illness. It has been developed in order to present a different perspective of lifestyle-related diseases like cardiovascular diseases, obesity and diabetes (Jolley, et al. 2014). It is often seen that the population does not enjoy a condition of being healthy even though there has been more than enough medical advances. The model acknowledges that there are several factors which affect the condition of health. It could be access to health care systems or socioeconomic status.
To define health, it can be inferred that it is nothing but an extent of a person’s mental, social and physical wellbeing. Being a multi-dimensional concept, health is closely related to the social institution medicine which thrives to prevent, treat and diagnose illness as well as promoting health in various facets (Cockerham, 2016). Health care can be referred to as the provision of the services that the social institution medicine has to offer in order to treat health problems, to prevent and to diagnose it. It is of utmost necessity that there be effective healthcare services and appropriate medicines for the society to be able to function properly. Social actors of any society will not be able to perform their given roles in the society if their health degenerates or suffer from the lack of an effective healthcare system. Thus lending from the functionalist perspective of Talcott Parsons (Turner & Holton, 2014), it is safe to assume that premature death of any member of the society will be a hindrance in the way of carrying out social responsibilities and roles and perpetuate social disharmony. In other words, the premature death of any member of the society also prevents that social actor to fully return to the society. It is only evidence that a society which lacks proper medical assistance will offer nothing but greater difficulty to people who are already ill as they will be susceptible to more illness. On the other hand, it has been seen that a society in which there is no medical or healthcare system adequate for the social actors, even healthy people develop greater chances of falling sick. Apart from that, a person must be meeting some expectations if he or she is to be treated as a legitimately sick person. A sick person must be treated by the doctor or a physician, who according to Parsons definitely has a role to perform in validating the sickness of the ill person. Parsons has also estimated the patient and physician relationship as a hierarchical one. The physician is to give orders which must be carried out by the patient so as to return to the adequate state of being healthy. The criticism of Functional theory comes in the way for several reasons. The theory has ignored the fact that any social actor’s condition of health and the quality of medical care that they receive is dependent on the society and the class of society that one belongs to. Furthermore, it is safe to assume that the hierarchy that Parsons has talked about does not thoroughly imply on the current scenario as patient and physician relationship has moved from an authoritative one to a relationship where the patient consciously submits in order to be at the best state regarding his or her health. The second perspective, the conflict approach acknowledges the face that just like any other services, medical and health care services are also coagulated in the hands of the fortunate one from which, the disadvantaged mass has been exiled. It takes judgment, based on the fact that social inequality exists and the social actors at the bottom of affluence will inevitably suffer from the lack of healthcare services. The disparity between the rich and the poor and the channels that they receive health care through varies drastically. Conflict theorists also view physicians as the one who ate seeking to control the healthcare and medicine industry so as to centralize the means and channels of distribution. It has been also believed that social problems and medical problems are deeply entangled and intertwined. The physicians are said to have seized the healthcare industry so as to monopolize it and deprive the less affluent mass of its benefit by only catering to the affluent class. The health monopoly business has turned out in such a way that conflict theorists also believe that the physicians often turn social problems into medical problems. Once a social problem has been medicalized, it is often seen that the real reasons for that problem get ignored and no solution gets offered. For example, the healthcare industry has monopolized medicine at such an extent that alternative medicines are radically shunned by the healthcare professionals. Conflict theorists believe that although there must be possibilities that alternatives to medicine does work since there is no such evidence that all of the alternative medicines are ineffective, it is also the insecurity of the medical professionals that they radically oppose the very idea of an alternative medicine system. As soon as the alternative medicines start working, it is obvious that the monopoly of the medicine market will lose its centralized power hold and power position. The medicalization of social problems can be understood clearly in the form of eating disorders which are treated medically. Eating disorders have a deep connection to the societal ideas of beauty but instead of eradicating that menace, the healthcare professionals are more focused on treating the disorder by the use of medicines.
For the example of ADHD, it can be mentioned, that this particular disease was not even considered to be a disease before the discovery of Ritalin. Before the invention of Ritalin, ADHD was considered to be a state of hyper activity but as soon as the drug was discovered, the health professionals started tagging it as a disease only to be treated by Ritalin or some similar drugs. This gave the health professionals an excuse to encash the ADHD disease and make the most out of it. With conflict theorists’ harsh criticism of medical professional, it has also received flak. True, that medicine remains the most dominant form of health care but it is also necessary to understand that not all healthcare professional take monetary benefits as motivation for their respective jobs, there exists passionate doctors and medical professionals who thrive on the wellbeing of the mass. The third perspective, the symbolic interactionist approach views illness as a social construction (Carlson, 2013). This effectively means that this particular approach takes illness as having zero objective reality and believes that illness is a social construction which deems a member of the society to be sick or healthy based on different parameters. To take an example, the opium ban in the USA would be appropriate. Opium infused products were not seen as anything unnatural and harmful as over the counter products sold in the U.S.A contained questionable amounts of opium. Opium only became a menace, medically and legally as the prejudice against the Chinese became prevalent only to give birth to a complete ban of the substance (Gabe & Monaghan, 2013). Just like the opium dilemma, the obesity related prejudice was not present in the global scenario until recently. Pro obesity activists claim that the vilifying of fat people and the medicalization of obesity places too much importance on fat people just because they do not fit the society’s standard of beauty. It is only normal, that this approach has also received criticism. It is true that symbolic interactionist negates the facts that serious illness and ailments do exist and proper medical assistance must be taken when in need. It must be remembered that illness has a subjective as well as objective reality, which could coexist.
As a medical practitioner, one can always get caught in the labyrinth of hierarchy and power which are indigenous. Health service inequality exists just like any other inequality which creates barriers amongst divisions of the society. In fact the social divisions which are based on socio economic conditions decide the fate of each individual. An affluent citizen can easily get access and come close to reach the best of healthcare services but on the other hand, it is impossible for the non- affluent to get a reach of the best healthcare services (Mengesha, Dune, & Perz, 2016). Even with the intention of reaching the fringes of the best services, one might suffer for his or her socio-economic position in the Australian society (Artuso, et al. 2013). The biomedical model, a core implemented part of the health care system makes the procedures all the more expensive as it involves high quality technologies that cater to the needs of the human beings. Besides, the aboriginal and the indigenous tribe of the Australian land who live in the lowest strata of the socio economic system do suffer from the lack of proper medical interventions. It has also been seen that the children who are living in poverty will be the sufferers who do not have the channels to reach the best of the healthcare systems (Duckett, & Willcox, 2015). It can be safely assumed that the social consequences also affect one’s health and the lasting effects that one must suffer from the impact of the lack of a healthy body. Lifestyle diseases such as obesity, cardio vascular diseases that have been led by the obesity disorders are purely consequences of an unhealthy lifestyle. Some people have been seen developing over craving for food from mental health problems such as anxiety, self-esteem issues or depression. A patient can develop biological sickness that is obesity from overeating and a lack to take care of his or her own body (Halfon, et al. 2014). The will to live a healthy life and be free from ailments can go missing not only from the lack of a healthy lifestyle but different social stigma. It has been often noticed, that the obese kids are also the most bullied and the hurt that they face from the constant rebuttal leads them to find solace through the medium of food.
In conclusion, it can be inferred that power and hierarchy are inseparable aspects of the Australian healthcare system. It is pre-determined, that what quality of services one would receive from the medical and healthcare system. The position one occupies in the socio economic strata of the society determines his or her fate, thus the relationship between the patient and the physician is one that is subjected to the power play and a hierarchy where the physician plays a dominant role.
References
Artuso, S., Cargo, M., Brown, A., & Daniel, M. (2013). Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study. BMC Health Services Research, 13(1), 83.
Carlson, E. (2013). Precepting and symbolic interactionism–a theoretical look at preceptorship during clinical practice. Journal of Advanced Nursing, 69(2), 457-464.
Cockerham, W. C. (Ed.). (2016). The new Blackwell companion to medical sociology. John Wiley & Sons.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford University Press.
Gabe, J., & Monaghan, L. (2013). Key concepts in medical sociology. Sage.
Halfon, N., Larson, K., Lu, M., Tullis, E., & Russ, S. (2014). Lifecourse health development: past, present and future. Maternal and child health journal, 18(2), 344-365.
Henslin, J. M., Possamai, A. M., Possamai-Inesedy, A. L., Marjoribanks, T., & Elder, K. (2015). Sociology: A down to earth approach. Pearson Higher Education AU.
Jolley, G., Freeman, T., Baum, F., Hurley, C., Lawless, A., Bentley, M., … & Sanders, D. (2014). Health policy in South Australia 2003–10: primary health care workforce perceptions of the impact of policy change on health promotion. Health Promotion Journal of Australia, 25(2), 116-124.
Mengesha, Z. B., Dune, T., & Perz, J. (2016). Culturally and linguistically diverse women’s views and experiences of accessing sexual and reproductive health care in Australia: a systematic review. Sexual health, 13(4), 299-310.
Scambler, G. (Ed.). (2013). Habermas, critical theory and health. Routledge.
Turner, B. S., & Holton, R. J. (2014). Talcott Parsons on Economy and Society (RLE Social Theory). Routledge.
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