Limits of Medicine

By Mutea Rukwaru

Limits of Medicine is a book portraying the challenges of 21st century in the field of health delivery system and specifically the challenges facing doctors in their everyday work. The book takes the reader through definition of medical sociology, definition of health, key concepts in medical sociology, theories on health, social constructionism of disease and illness, medical pluralism, history of medicine, medical ethics, the power of medicine, pathways to the doctor, fear of modern hospital, doctor-patient relationship, compliance with drug regimes and challenges facing the modern doctor in a fluid and fast changing world. The book identifies the challenges facing the modern doctor who has to operate in a very competitive environment where they have to co-exist with the faith healers and traditional healers. It is a relationship of suspicion, yet they have to serve the same clientele. The book portrays the challenges faced by the patient, the doctor and the society in general in service delivery in health. This book show some gaps which will help clinicians and patients to be able to have a healthy relationship. The relationship between the doctor and the patient is very complex and sometime it requires a multidisciplinary approach. The doctors might find this book useful for it contains some information they were not taught in medical schools. The book will not only improve the patient-doctor relationship but it will also improve their personal lives outside the clinic and hospital. To the patient it will empower them so that they are able to negotiate their needs with the health providers.

• Language: English
• Publisher: Mutea Rukwaru
• Release date: Aug 6, 2020
• ISBN: 9781005436001

Mutea Rukwaru

Mutea Rukwaru is an accomplished author of international reputation.He is an author of 17 bestselling books. He has written widely in the areas of research and family. He has wide knowledge in world of practice having been in the Department of Social Development for 33 years and also being in the world of academia, that is Universities and Kenya Schools of Government.Some of the top selling books include:Anatomy of CrimeFinancial Success Every Family's DreamEducation at CrossroadTraining at its bestMilestones of lifeHow to be a better CounselorThe winning familyThe Tie that bindsHappy though marriedFundamentals of social researchWhat happy couples knowSuccessful time managementStatistics can be funStrong in the stormSnapshot view of Social ResearchSocial Research Methods a complete guidePowerful Proposal, Powerful PresentationUpcoming titles being published by Eureka publishers are: Limits of Medicine, Dreams of my Motherland and A Place to feel at HomeMutea Rukwaru holds a Masters of Arts in Sociology (Counseling) and a Bachelor of Arts (Sociology), Upper Second class honors from Nairobi University

Book preview

LIMITS

OF

MEDICINE

by

MUTEA RUKWARU

ISBN: 978-9966-085-92-4

Other books by Mutea Rukwaru

(In order of years of publication)

Happy though married (2003)

The Tie that Binds (2005)

Successful Time Management, the Challenge for the Modern Manager (2006)

What Happy Couples Know (2006 a)

Fundamentals of Social Research (2007)

Milestones of Life (2007 a)

How to be a Better Counsellor (2007 b)

Anatomy of Crime (2008)

Winning Family (2008 a)

Financial Success Every Family’s Dream (2008 b)

Education at Cross roads (2009)

Training at its Best (2010)

Social Research Methods : A Complete Guide

(2015)

Powerful Proposal Powerful Presentation (2015a)

Statistics Can be Fun (2016)

Snapshot View of Social Research (2017)

Strong in the storm (2017a)

Retirement Dreams (2018)

Published by EUREKA PUBLISHERS

P.O BOX 1414 – 60200 MERU

Copyright Mutea Rukwaru 2019

All rights reserved. No part of this book may be produced or transmitted in any form or by any means, electronic or mechanical including photocopying, recording or by any information storage or retrieval system, without written permission from the publisher and author except for the inclusion of quotations in a review.

Cover Design was done by:-

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NAIROBI

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Typset by:

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MERU

Contact:

Website: www.mutearukwaru.com

Email: [e-mail]

Cellphone: [phone]

Acknowledgements

I am grateful to a number of doctors and laboratory technicians whom I had an opportunity to observe the behaviour of their patients in their clinics and laboratories, but who due to confidential reasons would not like their names to be mentioned.

Lastly, but not least I am grateful to Korongo my Medical Sociology lecturer in the University of Nairobi. His enthusiasm on the subject inculcated in me an interest to delve further into the intricate relationship of the medical professionals and their patients. However none of those acknowledged bear any responsibility to my work

MR.

Dedication.

I dedicate this book to wonderful and committed doctors and other health professionals whom despite being provoked by difficult patients still serve them with passion.

MR.

Preface.

Limits of Medicine is a book portraying the challenges of 21st century in the field of health delivery system and specifically the challenges facing doctors in their everyday work. The book takes the reader through definition of medical sociology, definition of health, key concepts in medical sociology, theories on health, social constructionism of disease and illness, medical pluralism, history of medicine, medical ethics, the power of medicine, pathways to the doctor, fear of modern hospital, doctor-patient relationship, compliance with drug regimes and challenges facing the modern doctor in a fluid and fast changing world. The book identifies the challenges facing the modern doctor who has to operate in a very competitive environment where they have to co-exist with the faith healers and traditional healers. It is a relationship of suspicion, yet they have to serve the same clientele. The book portrays the challenges faced by the patient, the doctor and the society in general in service delivery in health. This book show some gaps which will help clinicians and patients to be able to have a healthy relationship. The relationship between the doctor and the patient is very complex and sometime it requires a multidisciplinary approach. The doctors might find this book useful for it contains some information they were not taught in medical schools. The book will not only improve the patient-doctor relationship but it will also improve their personal lives outside the clinic and hospital. To the patient it will empower them so that they are able to negotiate their needs with the health providers.

MR.

Contents

Other books by Mutea Rukwaru ii

Acknowledgements iv

Dedication. v

Preface. vi

CHAPTER ONE 1

INTRODUCTION 1

Medical Sociology 1

CHAPTER TWO 6

HEALTH 6

Medical definition of health. 6

CHAPTER THREE 9

Key Concepts in Medical Sociology 9

CHAPTER FOUR 19

Theories on health 19

CHAPTER FIVE 32

Medical pluralism 32

Popular sector. 33

Folk sector. 35

Professional sector. 36

CHAPTER SIX 37

History of Medicine. 37

CHAPTER SEVEN 48

Medical ethics 48

Hippocratic Oath (Original) 50

Original Nightingale Pledge. 56

CHAPTER EIGHT 67

Power of Modern Medicine and the power of the doctor. 67

CHAPTER NINE 71

Pathways to the doctor 71

Why patients fear to see a doctor 73

CHAPTER TEN 76

Fear of the modern hospital. 76

CHAPTER ELEVEN 84

Doctor-patient relationships 84

Use of technology 92

CHAPTER TWELVE 109

Difficult patients and the doctors. 109

How to deal with difficult patients. 111

CHAPTER THIRTEEN 115

Patients and drugs compliance 115

Importance of medication compliance 115

Factors contributing to non-compliance. 116

How to improve compliance. 117

CHAPTER FOURTEEN 121

Doctor, patient and death. 121

CHAPTER FIFTEEN 126

Doctors in changing times. 127

Family 130

Doctor’s health 134

Doctors Retirement 136

Bibliography 138

CHAPTER ONE

INTRODUCTION

Medical Sociology

Definition – Medical Sociology is the Sociological analysis of medical organizations and institutions, the production of knowledge and selection of methods, the actions and interactions of healthcare professions and the social or cultural effects of medical practice. Medical sociologists are also interested in the qualitative experiences of patients. Early work in medical sociology was conducted by Lawrence J Henderson whose theoretical interests in the work of Vilfredo Pareto inspired Talcott Parsons interests in sociological system theory. Parsons is one of the founding fathers of medical sociology and applied social role theory to interactional relations between the sick people and others. (see en.wikipedia.org/…/medical-sociology).

Medical Sociology is a relatively new discipline and it was popularized through the works of Talcott Parsons who was a social scientist who tried to bridge the gap between medical science and social science. In the areas of medical science there was an emphasis on objectivity which medical professionals believed could only be found in natural sciences. It was believed that social scientists were subjective and for this reason medical doctors did not appreciate the role of social scientists.

Medical Sociology is a branch of sociology that investigates the social context of diseases and illnesses. Doctors will focus on biomedical while medical sociologists will focus on the social context. The medical sociologist goes beyond the biomedical interpretation. This is a departure from the view of biomedical scientists who focuses on the body. Medical Sociology focuses on the social definition of health and this includes:

The social meanings attached to different health status.

Seeks to understand implications of these social meanings in the way of managing diseases.

Stigma attached to diseases.

Medical Sociology focus on how members of society defines their well being based on the understanding that health is a subjective concept whose assessment keeps changing. For instance to the rich, health is defined by the physician and to the poor person sickness is defined by lack of food. Wellness differ from culture to culture or from social class to social class. Assessment of wellness varies from one context to another and therefore is a subject of inquiry. Medical Sociology examines health seeking behaviour and this includes the actions that people take on the onset of symptoms. What determines if a patient will see a doctor? Why go to prayer meetings when sick? Why go to a witch doctor when sick? Why are men not likely to go to hospital when sick while the reverse is true for women?

Medical sociology also examines social organization of healthcare delivery. It examines for instance:

Why are most gynaecologists men and not women?

Why do women prefer male gynaecologists?

What determines the gender division of labour in medicine?

Medical Sociology examines the relationship between healers, doctors and patients. It attempts to answer the following questions:

What is the relationship between a medical doctor and a patient?

What is the relationship between a witchdoctor and a patient?

How do healers relate to patients?

How do patients in private clinics behave compared to those in public facilities?

Does age difference between the patient and the doctor matter?

What determines patients compliance to drug regime?

What about the technology involved?

How does technology affect womens’ perception in reference to delivery?

Role of Medical Sociology in Modern Medicine.

Medical Sociology uses three levels of analysis namely Individual, Social and Societal. At individual level of analysis, Medical Sociologists focuses on the perception from individual viewpoint. This is what is called phenomenological inquiry. It attempts to understand diseases and illnesses from the perspective of the patient. At social level the medical sociologists examines the social context of diseases and illnesses and this includes the social meaning that is attached to diseases and illnesses and why for instance does society stigmatize syphilis and not malaria?

The third level of analysis is the societal level. At this level the medical sociologists focuses on the social organizations of health care across different societies or cultures. These three levels of analysis assist in understanding the role of medical sociology in modern health care system. Based on these three levels of analysis, medical sociology plays the following roles:

Medical Sociology helps to demystify the profession of medicine by critically examining patients and their illnesses for instance, why should the patient come to the doctor when he or she is dying or why does