A Critique of Anglo-American Medical Sociology

Abstract

After a period of rapid, stormy development, many people in the field tend to feel somewhat discouraged about the present and future state of medical sociology. Measured by the expectations of the public, the patients, and medical sociology itself, there is much disappointment. The predictive power of the tools of medical sociology has proven to be weak, and it has not been able to explain satisfactorily the impact of social inequality on the distribution of disease and on differences in the utilization of health services. It cannot even be ruled out that medical sociology itself has created some of these differences and that it is partly responsible for creating “two-class medicine” in the United States and elsewhere. Social epidemiology has failed to develop useful theories, nor could it deliver unanimous findings. A particularly serious flaw is the confusion between the concepts of class, social strata, and poverty. Medical sociology has become the propaganda machine of the Welfare State (in the sense used by Alwin W. Gouldner) and instead of questioning medical values it has been co-opted by their proponents and adopted them. Parochialism characterizes both research and publications. The new vogue of “internationalism” has not succeeded in creating truly international studies; also, it has not worked to the advantage of other countries and has not been helpful in creating a theoretical and empirical body of knowledge in health services research. The paper argues that a more realistic exchange between Anglo-American and other medical sociology, between conservative and radical thinking, and between medical sociology and general or specific fields of sociology would foster new ideas and a new understanding of the main problem, that is, of theory versus application, in health services research.