Culture

The Rationalization of Medicine

This was written as an opinion piece for my sociology class. Rationalization is the process of increasing efficiency through actions based on regulation and calculation, rather than on emotion, morality, or tradition. 

While this work maybe a little dramatic, it discusses many of the observations and experiences I’ve had concerning health care. Let me know if you want information about the outside sources. 

Has modern medicine become a science, or does it remain an art? The physician of today exists in a workplace vastly different than the physician of yesterday, and his reliance on pre-determined procedures reflects this. Unlike the local doctor of the past who provided a nurturing home visit, present day specialists provide a pill. Every installment of medical code economizes the process of diagnosis and treatment, as well as the doctor-patient relationship. Although regulation in the medical field is beneficial, it also has a dehumanizing influence. When rationalized methodology is placed upon society, both patients and health care professionals lose sight of the human compassion and concern that defines medicine.

At its origin, medicine was integrated with religion, politics, and holistic wellbeing. Most ancient cultures esteemed doctors as leaders and advisors, since they understood both the spiritual and biological realms. Creation of home-made remedies, community caregiving, and therapy were a physician’s common functions, motivated by affectual societal action. Moreover, there was heavy dependency on the doctor’s opinion, because the doctor-patient connection was strong, well-founded, and long-lasting. One man made performed all the diagnoses, all the surgeries, all the births, for one population.

Fast forward to the 21st century- and individuals can self-diagnose using search engines, countless patients are ushered through waiting rooms, and physicians implement care-plans based off the patient profiles on their iPads. This dramatic rationalization from natural treatments to calculated pharmaceuticals, and an open community doctor to a tightly scheduled cardiologist, was created by the need for specialization.

Specialization is a natural product of the study of medicine, since the human body is a unit of endless investigation. As physiological knowledge increases through research, it is distributed to various physicians to process and apply, “In this century it was possible for a single brain to accommodate most of the contemporary medical knowledge that might be of practical use to a patient. However, today the provision of optimum diagnosis and treatment requires many physician-specialists and an army of healthcare personnel with a wide range of expertise” (Goldbloom). The formation of specialties became medicine’s own division of labor, and it called for bureaucratization.

Modern healthcare is now defined by a chain of references; it breaks down treatment of the intricate human body into manageable parts (Miller). Every person may have a primary care doctor, and depending on their ailment may be referred to a dermatologist, then a psychiatrist, and so on. While this system supports Durkheim’s anticipation of organic solidarity, it also could be seen as a confirmation of Weber’s fears. Rather than multiple specialists collaborating to decide a patient’s treatment, the patient passes from one physician to another. In an extreme sense, it is a form of guess and check. If one doctor’s solution fails, the patient may then be sent to another specialist where the diagnosis process is repeated.

During this the patient’s identity can be lost, “Everyone recognizes that this unavoidable fragmentation of responsibility can bewilder the patient… to who his or her physician is. The mythical ‘health care team’ often seems to have no identified captain, and the patient longs for the kindly, omniscient family physician who seems to understand the problem” (Goldbloom). On the other hand, this system presents structure to the field of medicine, and it is technically superior to have one professional focus on one area rather than generally study all. Doctors must develop an interaction through which they can combine their knowledge.

Another crucial factor rationalizing medicine is time. For most institutions it appears the focus is on patient quantity and predictability instead of quality, features discussed by Ritzer. For instance, the desire for efficiency standardizes medical decisions and restricts variation between individual physicians (Ritchey). Instead of attempting to understand and diagnose patients through their own unique or case-by-case means, doctors today follow a general, scientific-like protocol. The “iron cage” of medicine could be seen as the system of appointments used by clinics and practices.

Doctors run a crunched schedule of patient-after-patient, in coordination with secretaries and nurses. Within this orderly process, there is the odd contradiction of time. For most, it appears that one waits for over an hour, and then is with the doctor for only ten minutes. As the doctor tries to squeeze in as many patients as possible, it leads to rushed examinations where patient complaints are stacked to identify a disease or conclusion. There lacks interpersonal connection, and usually the psychological causes of a patient’s condition are overlooked.

With rationalization in medicine there has been dramatic changes in expectations. Patients desire an automatic illness detection and medication, and physicians feel they can give them. Rationalization of medical science and application have built this illusion. What once was a human service is becoming a bureaucracy for cures. The modern healthcare system appears functional and fast, yet it cannot afford to dismiss the social arts that make medicine a humanitarian effort.

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