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Medical Dominance is the dominance that medical practitioners and doctors displayed over other healthcare practices, patients, and the healthcare system. The doctors regarded themselves as a social elite and strongly endorsed the view that they could dominate and dictate the working and practices of the healthcare system. This paper provides an overview of medical dominance and where it currently stands.
What is medical dominance
Coburn (Coburn 2006) has provided meaning for the concept of medical dominance. According to the author, Medicine had assumed the dominant source of power with regards to healthcare and treatment of patients. Medical Dominance means the dominance by Doctors over the work over other healthcare occupations, control of clients, and control of conditions and terms of work. Since medical care and specifically doctors practice a profession and not an occupation, all regulatory power mechanisms are self-regulatory and the author suggests that practitioners have usurped this power to subjugate and dominate over all other medical practices. Coburn has cited the work of several researchers to prove the argument. The author has presented examples of Complementary and Alternative Medicine processes such as chiropractic, acupuncture, naturopathy, and others. Qualified doctors treated such practices as underdogs and many serious criticisms were raised about such therapies. Using concepts of Sociology, the author has argued that medical dominance was actually a form of knowledge power in which a few individuals had the knowledge to provide medical care and this prevented any outside control or administration. Coburn speaks of intolerance among doctors when questions were raised about the care they gave or when patients demanded more information about the care they received. The attitude spoke of a superiority complex and the elite practitioners and the professional bodies to which they belonged, evaded giving any accountability or disciplining their members.
Coburn has provided some insight into how medicine rose to its dominant power and he suggests that medicine rose to its dominance by persuading the public about its efficacy and gained a legal monopoly with the sponsorship of the social elite and the state. Prior to the 1970s, the medical profession was made up of doctors who could be regarded as the social elite and this further increased their determination to sustain the dominance of medicine over other forms. It also gained dominance by its control of medical schools, the technology, sciences, and the scientists that supported it. This type of attitude had made the medical professionals subject to public outcry and a few notable scandals have brought fresh interest in enforcing some type of discipline among them.
Dent (Dent 2006) has reported that medical dominance has been subdued with the introduction of the social healthcare system in which the treatment and healthcare practices are subjected to external regulatory agencies. In the current scenario patients now have a greater say in their treatment and in the healthcare process. The author has given the example of NHS in Britain where the role of the patient has been changed from the earlier supplicant status to consumer and further to an active participant. This has brought some discipline among medical professionals and made them more accountable for the treatment they give and the costs and budgets they need to follow.
What field is it most predominant?
As per the research done by Coburn (2006) and Dent (2006), medical dominance is most predominant among doctors and doctors with further specialization. It is not so pronounced in other healthcare professionals such as Nursing, Pre-hospital, and ambulance services.
Medical dominance is the manner in which doctors and healthcare professionals seek to dominate over other healthcare functions and over the treatment that patients receive. The term refers to intolerance on the part of the doctors to be accountable for the treatment they gave and also suggests that doctors actively sought to reduce the impact of other complementary therapies. The paper discusses how with the advent of the social health welfare schemes, medical dominance is no more the force it was earlier.
- Coburn David (2006), ‘Medical Dominance then and now: critical reflections’, Journal of Health Sociology Review, Volume 15, Issue 5, pp: 432-443
- Dent Mike (2006), ‘Disciplining the medical profession? Implications of patient choice for medical dominance’, Journal of Health Sociology Review, Volume 15, Issue 5, pp: 458-468