In The Rise of the Modern Hospital, Rosenbergon discusses the medicalization of the hospital setting and the hospitalization of physicians and private practice. As mentioned in lecture, he discusses how hospitals transformed into a fully integrated medical setting from a previously personalized, potentially less effective social model. This joining of healthcare directly coincides with other articles discussing over-medicalization, which brings up the question: was the hospitalization of physicians potentially one of the first steps in over-medicalization of society? Though critical to our idea and perceptions of modern day hospitals, did this transformation push hospitals to be too medical for proper health and healing?
As suggested by the article written by Nicholas Bakalar of The New York Times, one’s marriage status may increase one’s likelihood to recover from serious surgery. Such a statement takes support from a study conducted by JAMA Surgery, a monthly medical journal published by the AMA, which included approximately 1,567 individuals who had cardiac operations and ranged between 50 and older. Of the 1,567 research participants 1,026 individuals were married, 184 were divorced or separated, 331 were widowed, and 35 were never married. Information regarding their need for aid in six specific ways prior to the surgeries was first recorded, and then compared to similar data collected two years after the operations. The six activities included rising from bed, walking, bathing, dressing, and consuming food. The results showed that roughly 20% of married individuals pass on or increase in dependency, whereas 28.8% and 33.8% of divorced/separated and widowed individuals showed similar outcomes, respectively, even after factors like personal habits were controlled for. The survey is praised for the implications it poses on social supports on patient health outcomes.
While the studies does shine light on the importance of support systems for patients, researchers limit themselves by the use of labels like “marriage,” “never married, etc. Marriage does not necessarily equate to the reciprocation of care and comfort, as individuals may fall out of love while holding such a status, compelling them to perhaps despise and or cheat on their partner. In addition, marriage is sometimes used as a tool to gain individual benefits between two parties, and in such cases may not entitle one to receive such personal care from their partner. In contrast, individuals who have never married may receive care and comfort more so than those of married couples. Non-marriage does in no way characterize the lack of social support. For example, the LGBT community has spent many years fighting for the status of marriage, and has very recently made profound advancements in its goals nationwide. Many of this community, while not legally married, upheld relationships or familial units similar to society’s ideal conceptions of married units, displaying that support can be received outside the confines of “marriage.” Also, the inclination to pursue the institution of marriage has waned amongst the younger generations over the years, regardless of their sexual preference, thus increasing the likelihood of long-term couples with supporting partners that may not fall into the categories established in the study described above. The result of non-married individuals are not even included within the results reported by the article, providing an inaccurate view on the social implications of the study. Factors such as whether individuals remained in hospital care or were discharge home were not mentioned either, or whom played a primary role in patient recovery care.
In Smith’s and Kleinman’s article, “Managing Emotions in Medical School: Students’ Contacts with the Living and the Dead”, they analyze doctor-patient relationship and how medical schools try to desensitize medical students in the effort to control emotions that medical situations provoke. Medical schools want to emphasize the importance of keeping a professional relationship with their patients and not let their emotions get involved as it may cloud their clinical judgements and medical decisions.
I have shadowed many doctors before and what they thought me was to “treat the patient first, then treat the illness”. They also emphasized the point where relationship with patients is the key to gain their trust and it makes it easier to provide better care for them. This makes me question this article as to why medical schools would want to desensitize medical student’s emotions while dealing with patients. I understand that there still needs to be a professional relationship with your patient, but to what extend does that need to be fulfilled as to what the article was explaining? If one were to desensitize their emotions, I feel that in any given circumstance, the doctor will do whatever in their power to provide the best outcomes and quality service to their patient. My question is that do you think that keeping it “strictly professional” provides better health outcomes? Because of this, will medical professionals lose their sensitivity towards the people they serve? If it does provide better health outcomes, is it better to have better health outcomes or decrease the quality of service to their patients? When it comes to one’s health, does a professional relationship outweigh the interpersonal doctor-patient relationship?
In Patricia Rieker’s article “Understanding Gender and Health: Old patterns, New Trends, and Future Directions,” readers are forced to confront how men and women differ in health in terms of not only life expectancy, but also prevalence and onset of various mental and physical diseases. She argues for a constrained choice model in health, a model that illuminates how individual responsibility in health is actually a shared decision by makers such as family, community, and policy makers. Thus, according to the article, individual choices, these other makers, and biological processes all contribute together to differences between women and men in health.