In The Social System: The Major Exposition of the Author’s Conceptual Scheme for the Analysis of the Dynamics of the Social System, Talcott Parsons identifies a number of ways in which the modern medical practice has evolved into a complex social system. As Parsons begins to outline his chapter dedicated to medicine, he makes an interesting statement in that illness is not only disturbance in the “normal” functioning of the biological system, but also the individual’s personal and social adjustments (Parsons, 1964, p. 431). When a person has been labeled as “ill,” whether through their own evaluation of health, or by the determination of others, and the severity of their illness dictates that they must seek medical treatment, they enter into a very interesting social system.
Once the person in need of treatment has engaged in a relationship with a physician, they find themselves in a dynamic that has now moved them from the sole category of being sick, into a relationship in which they must “cooperate” with the decisions of the physician, who has been labeled as a technically competent specialist who must now get the individual well. What is interesting in this relationship is that the patient, in their “sick role” has been classified as helpless, and in need of help, and contrary to Parsons explanation of other deviant roles in which case an individual falls outside the boundaries of what is “normal,” those in the sick role, can’t help it (Parsons, 1964, p. 440). In the sick role, the patient no longer has responsibility for their health, but they have now placed the power of healing into the hands of the physician.
This removal of themselves from their care is extended once the physician is brought into the relationship because now the healing process has been transformed into a scientific process that requires highly specialized education and training. The sick person is given another level of disability within the relationship, because he is now not only sick, but he is not in a position to care for himself, and he does not know what needs to be done, or how to do it (Parsons, 1964, p. 441). The concepts of medicine are above that of a layman, and therefore a large communication gap begins to emerge. This communication gap widens as the patient and his family begin to place unbridled trust into the physician due to a lack of knowledge of medicine. The patient may not feel competent enough to decide when he needs to seek another physician, because he may be unaware of how to gauge the technical competency of one over another. His choice in physician likely came from the recommendation of a friend or family member, or in today’s online world, through a glowing Yelp review. Parsons notes that in general, a layman is not “qualified to choose the ‘best’ physician among a panel” (Parsons, 1964, p. 441). The patient and his family must place a very large amount of trust in a physician’s medical abilities without, in most cases, truly understanding the specialty in which the physician operates.
This dynamic places the patient and their family in a complex situation of emotional adjustment, one that Parsons labels “a situation of strain” (Parsons, 1964, p. 442). The patient being removed from their “normal” day-to-day activities further burdens this strain. The patient may understand that he is experiencing specific symptoms, but he is relying on the scientific training of the physician to identify the correct treatment plans, which in some cases may be none. In some extreme cases, the only thing a physician is able to do is to determine that there is nothing that can be done, and in essence destroy the hope of the patient (Parsons, 1964, p. 448).
Parsons make an interesting observation of medicine in regards to its scientific properties: “Like that of all scientific advance, is to increase awareness of the vast extent of human ignorance even in the most sophisticated fields of applied science” (Parsons, 1964, p. 450). Even though a physician may have received extensive and specialized technical training, uncertainty factors dictate that positive outcomes cannot be guaranteed. Parsons notes that belief in healing also makes a difference, but there is a downside to having too much belief in the science of medicine. Parsons explains that there is a common trait shared by patients and physicians in that it is better to do something rather than nothing, even if there is not substantial evidence to make a treatment decision (Parsons, 1964, p. 466). There is a tendency in medicine to treat physicians as cultural heroes who heal. There is also a noted tendency for the medical field to slowly adopt innovation, but when it does it spreads rapidly and is utilized whenever possible, before it levels out.
So in essence, the medical system operates by creating sick roles that are managed by physicians who have been granted substantial powers over their patients. Physicians are then prompted to take action to heal the patient based on a semi-flawed trust that is placed in an unstable and fluid scientific field. Parsons’ work supports the goals of the current project in the sense that the current project aims to help bridge the communication gap between the layman, whether this be the patient or a patient’s family, and the technical specialist. Other works have suggested that the field of medicine could be improved through the empowerment of patients, and the most effective way of providing this empowerment appears to be through better communication.
Parsons, T. (1964). The Social System: The Major Exposition of the Author’s Conceptual Scheme for the Analysis of the Dynamics of the Social System. New York, NY: The Free Press.