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Sociology of Healthcare: Medicalization and Its
Implications for Stakeholders
The
healthcare system is a complex mechanism that brings numerous stakeholders
together to achieve individual and collective goals. Medical professionals,
consumers, and pharmaceutical companies engage in sophisticated interactions to
ensure better public health outcomes. Simultaneously, each of them seeks to
satisfy his or her individual professional, financial, or career interests.
With the growing power of pharmaceutical companies in shaping the healthcare
landscape, they also come to represent a potent instrument for shaping and
redirecting consumer behaviors. Medicalization is emerging as one of the
defining features of healthcare as a social organism. However, it is not a new
concept. For decades, pharmaceutical companies in active collaboration with physicians
have sought to expand their consumer base by medicalizing human behaviors that
would have been otherwise considered as healthy. Medicalization can bring
positive and negative consequences, but it will gradually become more
problematic, as more consumers acquire access to comprehensive health
information and create an entirely new social context, based on health
awareness, informed decision making, and rationalism.
Medicalization
is gradually emerging as a distinctive feature of the healthcare system. In
general terms, medicalization implies that medical professionals determine the
criteria for health and pathology and assume the key role in deciding what
behaviors and features should be regarded as healthy and which one require
medical treatment (Maturo 123). In this respect, the
term "medicalization" does not seem to be problematic. For centuries,
doctors enjoyed unilateral power to make diagnoses and cure diseases. However,
with the rise of the pharmaceutical industry, medicalization has come to exemplify
an entirely different social process. Today, it is entails "the extension
of medicine's jurisdiction over erstwhile 'normal' life events and
experiences" (Ballard & Elston 228). In
other words, medicalization reconceptualizes healthy behaviors as non-healthy.
It is intended to raise public awareness of their disease status and force them
into purchasing pharmaceuticals to treat the newly diagnosed health condition.
The world has seen numerous instances of inappropriate medicalization. Many
human behaviors and social conditions have been reconsidered to become a
medical diagnosis, including baldness and social phobia (Moynihan & Henry
886). The social benefits of medicalization are questionable. Yet, as long as
it brings enormous profits to pharmaceutical manufacturers, they will use a
diversity of strategies to medicalize the developed world.
That
the pharmaceutical industry plays the central role in setting the direction for
medicalization trends is an obvious fact. The past decades witnessed the rapid
popularization of numerous diseases and conditions, which are claimed to
require pharmaceutical treatment. Pharmaceutical manufacturers develop
sophisticated strategies to reach the potential consumer. Direct-to-consumer
marketing is one of the predominant means of attracting new customers. Kitsis writes that, in 2005 alone, pharmaceutical companies
spent $4.2 billion on DTC. "While this approach does not necessarily
result in the redefinition of new disease, it can facilitate the expansion of a
market, as in case of social phobia and erectile dysfunction" (Kitsis).
In
other instances, pharmaceutical manufacturers develop informal alliances with
healthcare professionals to convey a compelling message about a new disease and
convince the target audience that they can cure or prevent the condition with a
new drug (Moynihan & Henry 886). Such informal alliances target primarily
popular media with the goal of creating a sense of fear in consumers and
attracting their attention to the "curability" of the selected health
problem (Moynihan & Henry 886). Pharmaceutical companies invest huge
resources in creating the boards of "independent experts", who tell
the stories of miraculous cures (Moynihan & Henry 886). They sponsor the
so-called "victims" of the most devastating diseases, who share the
narratives of their positive experiences using breakthrough medications
(Moynihan & Henry 886). All these processes can be defined as
"interactional medicalization", when physicians, consumers, and
pharmaceutical companies collaboratively redefine a social problem into medical
one (Maturo 124). It is a product of multiple factors
and brings numerous effects on all major stakeholders of the healthcare system.
Numerous
factors stand behind the growing scope of medicalization in the 21st
century society. However, the three most serious ones include commodification
of health and healthcare, the unprecedented pace of technological advancement,
and the emergence of managed care frameworks (Maturo
125). More specifically, consumes drive medicalization of their behaviors, by
prioritizing health above other social needs. More individuals prioritize
health and wellness over other needs. Technology also facilitates and speeds up
medicalization. Ultimately, profit-oriented managed care organizations
legitimize medical treatment of the conditions that were previously believed to
be non-medical (Maturo 125). They also encourage
consumers to engage in self-diagnosis to discover their diseases and request
timely medical treatment (Maturo 125). All these
processes profoundly alter the social context in the healthcare system.
The
pharmaceutical companies are the first in line to benefit from medicalization,
through increased profits and the growing customer base. However, companies
that supply obviously misleading health information or falsify the benefits and
risks of their drugs operate at a thin edge. They may face substantial fines,
if their manipulations to increase profits and revenues are discovered. In 2007
alone, the Federal Drug Administration levied fines equal to $500,000 for
misleading and false medication advertisements (Kitsis).
The ethical side of misleading health information also should not be
disregarded.
In a
similar vein, medicalization has positive and negative implications for the
healthcare industry. On the one hand, it motivates healthcare professionals to
redefine the meaning of the most prevalent diseases and motivate consumers to
be more sensitive to the signs and symptoms of various health disorders. It
also changes the direction of efforts in medical education, changing
physicians' attitudes towards routine health problems and ensuring the
provision of quality medications before these problems become irreversible or
untreatable (Blackburn). On the other hand, with the growing pressure to take
medications, the healthcare system may face serious backlash. Medicalization
increases the burden of healthcare costs (Blackburn). It also disrupts the
atmosphere of trust that had historically defined the direction of
consumer-physician relationships.
Finally,
the effects of medicalization on everyday people are far from being uniform. By
redefining social problems as medical ones, pharmaceutical companies may
potentially contribute to the development of more equitable treatment
approaches. That is, individuals with conditions that were previously
considered as non-medical will have a chance to receive quality medical
treatment as part of their insurance coverage (Blackburn). At the same time,
with the growing abundance of information, consumers may fail to distinguish
between credible and non-credible information. They may also face adverse
effects of medications, whose benefits and risks were not appropriately
communicated to the target audience (Moynihan & Henry 886). Yet, there are chances
that consumers in the 21st century will take the information
provided by pharmaceutical companies for granted are minor.
The
social landscape in the healthcare system is changing, leading to greater
engagement of consumers in information management and exchange. Such consumers
are better equipped with medical knowledge. They are aware of the uncertainty
surrounding treatment decisions (Ballard & Elston
228). Therefore, they are also likely to resist medicalization (Ballard & Elston 228). The latter, however, will still remain one of
the dominant trends affecting healthcare. This is why its consequences and
implications for public health should be thoroughly explored.
To
sum up, medicalization is a complex social trend that encompasses numerous
factors. It has both positive and negative impacts on the healthcare system,
pharmaceutical companies, and consumers. On the positive side, medicalization
raises public awareness of the most challenging health conditions. It increases
profits and revenues in the pharmaceutical industry and promises to ensure more
equitable provision of healthcare services. Misinformation and futile treatment
are the principal downsides of medicalization. However, in the age of advanced
information technologies, more consumers are likely to resist these trends. The
future of healthcare as a social system is likely to be rooted in the
principles of transparency, and accountability, and rational decision making.
Still, medicalization is likely to remain one of the dominant social trends in
the coming decades.
Works Cited
Ballard, Karen
& Mary Ann Eston. "Medicalization: A
Multi-Dimensional Concept." Social Theory
& Health, 3 (2005): 228-241. Print.
Blackburn, George
L. "Medicalizing Obesity: Individual, Economic, and Medical Consequences."
Journal of Ethics, 13.12 (2011):
890-895. Print.
Kitsis, Elizabeth A. "The Pharmaceutical Industry's
Role in Defining Illness." AMA
Journal of Ethics, 13.12 (2011): 906-911. Print.
Maturo, Antonio. "Medicalization: Current Concept and
Future Directions in a Bionic Society." Mens Sana Monograph, 10.1 (2012): 122-133. Print.
Moynihan, Ray,
Iona Heath, & David Henry. "Selling Sickness: The Pharmaceutical
Industry and Disease Mongering." British
Medical Journal, 324 (2002): 886-891. Print.
