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.
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.