Conrad Shifting Engins 3-2-1 Reading #12
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Apr 3, 2024
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3-2-1 Reading Reflection
Name: Author: Peter Conrad
Title: Conrad Shifting Engines T
he Shifting Engines of Medicalization
1.
Briefly list 3
take-away points
Rise of Medicalization: Studies of the medicalization of hyperactivity, child abuse,
menopause, post-traumatic stress disorder (PTSD), and alcoholism, among others, broadened our understanding of the range of medicalization and the attendant social processes. If one conducted a meta-analysis of the studies from the 1970s and 1980s several social factors would predominate.
Changes in Medicine: There was an erosion of medical authority (Starr 1982), health policy shifted from concerns of access to cost control, and managed
care became central. As Donald Light (1993) has pointed out, countervailing powers among buyers, providers, and payers changed the balance of influence among professions and other social institutions. By the 1990s the Human Genome project, the $3 billion venture to map the entire human genome, was
launched, with a draft completed in 2000. In a recent paper, Adele Clarke and her colleagues (2003) argue that medicalization is intensifying and being transformed.
Emergent Engines of Medicalization: Three major changes in medical knowledge and organization have engendered a shift in the engines that drive medicalization in Western societies: biotechnology such as forceps or drugs used
during childbirth, consumers, and managed care. with $10.9 billion in sales in 2003 have become the third bestselling class of drugs in the United States (IMS Health 2004). At the other end of the life spectrum, it is likely that the $400 billion Medicare drug benefit, despite its limits, may increase pharmaceutical treatments for a range of elder problems as well.
Consumers: We now are consumers in choosing health insurance plans, purchasing health care in the marketplace, and selecting institutions of care. Cosmetic surgery is the exemplar of consumers in medicine (Sullivan 2001). Procedures from tummy tucks to liposuction to nose jobs to breast augmentation have become big medical business.
Managed Care: Over the past two decades, managed care organizations have come to dominate health care delivery in the United States largely in response
to rising health care costs. Managed care has become a factor in the increasing uses of psychotropic medications among adults and children. Many managed
care organizations have concluded that it is a better financial investment to cover gastric bypass surgery for a “morbidly obese” person than to pay for the treatment of all the potential medical sequelae including diabetes, stroke,
heart conditions, and muscular skeletal problems.
Medicalization in the new Millennium: Doctors are still gatekeepers for medical
treatment, but their role has become more subordinate in the expansion or contraction of medicalization.
2.
What are 2
questions you have about the readings?
What is Medicalization? When you ask younger people, I assume they have no idea, and these are the people of our future. We need to have a better understanding of it as it is the treatment and conditions of our medical issues.
Do we really need all the medications prescribed? I think this is more about money and less about the treatment of the patient. 3.
Write up a quote you liked from the readings. In a few sentences explain why you
selected the quote (give the page number for your quote).
The body has become a project, from “extreme makeover” to minor touch ups, and medicine has become the vehicle for improvement. P.7
This is something people do more to look better than for medical reasons.
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