Functionalists believe that in order for society to flow smoothly, a reliable and effective health care system needs to be in place. The health care professional and patient relationship is hierarchical, so that when a doctor asks a patient to follow a treatment plan they are expected to follow it. This is part of their responsibilities of the sick role (Parsons 1951). This relies on co-operation and trust on both sides though, the patient and healthcare professionals need to work together to ensure the fastest recovery possible.
Parsons (1951) created the sick role which allowed someone who was ill to have two rights, the right to be ill and the right to be relieved of partaking in normal activities. He also said that they had two responsibilities, to seek medical treatment and to allow themselves time to recover. Parsons also believed that doctors had a right to prescribe any medication that the patient may need and the responsibility to ensure that person was merged back into society as soon as possible.
Parsons proposed three different types of consultation:
Paternalistic model: This is where the doctor had the main power in the consultation and was able to prescribe any medication. The patient then had the right and the responsibility to accept any medication given.
Mutualistic model: This is the where the patient and the doctor had equal say in what they thought was the problem and the treatment in which the patient received.
Consumerist model: The patient had the main power in this consultation and would provide all the evidence as to what was wrong. They would effectively use the doctor in order to receive the medicine they believed they needed.
Parsons (1951) paternalistic model is very rarely seen within our current NHS system and whilst we see mainly a mutualistic model, even this is slowly making an exit as these models are not up to date enough for modern day society. With the NHS struggling to keep up with the amount of people requiring appointments, having a consultation where there is enough time for the doctor and patient to discuss and agree on a suitable treatment is hard to come by. As the NHS struggles to see to everybody, the patient doctor relationship is slowly becoming that of a sour one. People are venting their angers of overpopulation onto healthcare professionals as they healthcare system is failing to keep up with the demand.
Marxist:
Marxists believe that healthcare professionals have both good and bad motivations. Whilst they believe that these people are the most qualified to diagnose and treat people they also believe that healthcare professionals take full advantage of the financial gain that is possible. They may do this in such a way as to categorize social problems as medical problems even though they don’t have a full understanding of the problem. This may lead to patients not receiving correct treatment and is bringing forward the idea that money is more important than an individual’s healthcare.
Illich (1970) identified the health hazards of the ‘medicalization of society’, pointing out how health care became a profit based organization. Whilst the working-class people were unaware of exploitation, the middle class took full advantage of this ensuring that the working class only just had sufficient enough health care as to make sure they could continue to work within the production line. Illich (1970) could see that the middle class were more worried about the money those workers could make them rather than themselves and their own families health and wellbeing. Whilst is may not have been as obvious back then, it is becoming clearer now a day with the increase in multimillion drug companies.
Our modern-day NHS is more of a production line than it has ever been as there are more and more bodies the squeeze into the system. Continuously aiming to reach higher money saving target and shortening time slots for appointments. All of this is taking a toll on how the doctors gain trust of their patients. Patients see themselves as parts on conveyer belts waiting to be seen resulting in lack of trust with the doctors. This also could start to take its toll in patients’ health, if people can’t get appointments, rather than continuing to try they will give up, meaning more people passing on illnesses to each other.
Interactionalist:
Interactionalists believe that whether intentional or not, healthcare professionals will take control of a situation to display their authority and knowledge. An example would be patients being called by their first name whilst the healthcare professionals are addressed as ‘doctor’ or ‘nurse’. Another example would be that healthcare professionals would allow the patients to have to wait a long time before being seen, to further prove that they are I control of the situation.
In Goffmans (1959) dramaturgical approach, he talks about how humans are active and knowledgeable beings and that we are active in deciding how we behave. He believes that humans are manipulative and that we want to control how other people view us, for example a doctor being seen in a white lab coat. Goffman sees people as con artists and that we only let people see the side of us that we want them to see.
Goffmans (1959) theory could be applied as to why doctors like to display authority and knowledge, they want you as a patient to see the good side to them. For example, if you saw a smartly dressed doctor with brushed hair and a dirty doctor dressed in casual clothes, you would want the first doctor to treat you. Not only does this allow the doctor to feel confident and allow them to work more effectively, it gives the patient more trust in the relationship. Whilst keeping a professional appearance and attitude, can give a good image of a person it may also create distance between the patient and doctor. If a patient from a lower class walks in they may find this intimidating and could result in the patient not feeling confident enough to fully explain the extent of the issue, this may affect the treatment and the overall outcome.
Feminist:
Feminists believe that women’s health care has been medicalized and that they are being treated unequally. They see that female birth control is more common practice than male birth control and feel it is unfair that the responsibility is left to women. Female procedure such as child birth has also been medicalized, leaving women feeling excluded from the planning of the birth of their own child.
Oakley (1970) looked into 66 women’s experiences of having their first babies, collecting much of her data through interviews. Some of the women had sleep deprivation and the shock to the system of becoming a mother and had been told by the healthcare professionals it was postnatal depression, which included further testing including taking the baby away constantly. Not only was this extremely upsetting to the mother and child, the health care professionals involved where not as sensitive about the situation as necessary.
Following Oakley’s (1970) research, procedures and guidelines were changed in accordance to ensure that women received better health care around child birth. Whilst the issue around childbirth is less of a problem now, relationships between healthcare professionals many issues are still present that are yet to be addressed. Birth control being directed as a responsibility of women rather than an equal responsibility, is still a problem, no research has been done into alternative birth controls.
One of the simplest issues within the health care system currently is that the senior roles are predominantly males. Female patients prefer to speak to female doctors, with a shortage of female senior roles, this can leave some patients unhappy with the relationship between themselves and their doctor.