1. Medicalization Renee Fox and the classic article in the field Conrad and the extension of medicalization Medicalization means that medicine assumes control over previously social, cultural and political issues and makes them fit medical diagnoses, treatment and social control patterns Example—alcohol as disease

2. Medicalization We make a social action as disease, categorize it, give it symptom complexes and means of “cure” Make people who “suffer” from it the victims and thus take away social responsibility for their actions and allow them the sick role, perhaps permanently—removes individual social responsibility

3. Medicalization Makes the “disease” more socially acceptable and also at the same time makes the disease more stigmatizing Labeling of social issues as medical Labeling theory

4. Critical Perspective Medical institutions as powerful and power hungry Stigma as social tool Promoting inequality—if you make someone a victim are they equal? Oppressive Counter-therapeutic Restrictive of the “right to be different”

5. Therefore Medicalizing some social action Brings it under the purview of medicine Allows medical labels and methods to control the discourse about it Has significant social consequences for the future of the “disease” Gives more power to medicine and Medical Industry

6. Application? How does this concept of medicalization apply to social and psychological “aberration” Example Drug abuse Alcohol Domestic abuse, child abuse Anger Obesity

7. Demedicalization The reverse process Assumes we are all responsible for our own well- being Makes the reverse assumptions about medicine and its ability to manage and help social ills Frees the individual from the sick role and makes them more personally responsible Makes society more responsible for “curing” social problems as social problems

8. Consequences of demedicalization Eliminates hierarchical doctor-patient relationships— more negotiation of health Patient required to be competent in medical matters, knowledgeable, negotiator and responsible Requires the doctor to be more communicative and less power oriented Who loses when this occurs—health institutions and governments—they lose control!

9. McDonaldization of medicine George Ritzer concept McDonalds has a specific way of doing things that gets their product, service to market Medicine is both market and service as well Fast, clean, client oriented, ordinary, unchanging (standardization) and not employee centered Breaks up employee tasks into small repeatable things that are boring and easily controlled

10. Fast We all want speed and immediacy in our care Where do we go? Now oriented—less responsibility on the patient, more of a client/customer

11. Clean New facilities and better technologies Less hands on Less art and more science

12. Client oriented Patients as customers Patient satisfaction as a measure of outcome Distasteful for most medical people and a measure of the industrialization of medicine

13. Ordinary Everyone gets the same impersonal care and products No nuance Not personal compassion and art of care

14. Unchanging Standardization Protocols Standards of care determined by national organizations, industry financiers and courts Medical controls of treatment diminishing

15. Not employee oriented Doctors do not control care Money increasingly implies level of care received Power in the institutions and the government Technology rules, not art

16. AND Increasing specialization, less personal relationships, doctor shopping We do not venture outside our narrow knowledge base—less Eureka! Moments We believe that this is better medicine

17. Downsides of this Less personal interaction and trust Grocery store mentality of patients Lack of personal responsibility on ANY party to the medical interaction and on the controllers of that action—no one runs the store

18. Examples Emergency medicine Boutique hospitals Heart scans Primary care