Medical sociology: an introduction

Bradby, H. Medical sociology: an introduction . London : Sage 2009 xi + 212 pp. £19.99 ISBN 987-1-4129-0219-9 (pbk) 978-1-4129-0218-2 (hbk ) As indicated by the simple, straightforward title, this book is an introductory text. It does, however, provide a different and complementary take on medical sociology. Bradby draws upon her experience of teaching graduate entry medical students in the UK, and her rounded and comprehensive knowledge of sociology and its application to medicine comes across clearly in this book. Her approach is to take a step back to consider the enterprise of medical sociology as a whole. She covers all the usual suspects, from macro-social perspectives on health inequalities to patient experiences of illness and stigma, as well as the organisation of healthcare. She does so in a reflective, critical way, providing a series of linked essays on the social nature of illness, healthcare and medicine. The style of the book is to question and problematise key contemporary issues in medical sociology which works to open things up for further consideration and study rather than to provide solutions or just describe the ‘facts’. This makes for a useful introductory text for medical students and teachers. The British General Medical Council regards the need for future doctors to learn about the social nature of illness as important for good medical practice. How does medical sociology inform good practice? It provides information about social influences on illness and it adopts a critical stance regarding the nature of illness, healthcare and medicine. This latter part is perhaps less emphasised in teaching medical students. The emphasis in training is to produce individual practitioners who will slot into the system when qualified. Bradby states in the preface that the book provides insights from a ‘critical social science perspective for a medical audience’. Part of the role of a medical sociology teacher is to contribute to the development of critical thinking skills in their students. A first year student commented to me recently, ‘Doctors are like mechanics – someone comes in with a problem, we fix it and send them out again’. If students left medical school thinking in that way they would be poorly equipped for work as a doctor. They need to be critical with regard to identifying patient problems and ways of managing them, and with regard to the nature and role of medical practice itself. Again, as Bradby states, ‘…medicine can be seen as being embedded in a political, economic and social context’ (p.194) and students need to have some understanding of how these aspects may affect the work of a doctor. Bradby provides a good introductory framework for looking at health, illness and medicine as social issues. Traditional topics in medical sociology are integrated with contemporary debates in the medical world. This will be useful for medical students who are interested in learning about these issues. Thinking about the medical students I teach, I believe that this book would be useful background reading for community-based medical education in general practice and hospital in the pre-clinical years where there is a focus on the social context, as well as for specific medical sociology teaching. The book is structured in an accessible way, with short chapters, clear aims at the start of chapters, definitions of key terms given at the beginning of chapters, questions for further study at the end of chapters (useful for teachers), and suggestions for further reading. Questions are asked throughout which will be useful in seminar discussions and small group work. The book is also interspersed with some interesting photographs which work well with the text. Having described and discussed issues across the breadth of medical sociology, Bradby sums up the relevance the discipline has to medicine and healthcare. In the end it is about providing patient-centred care, as opposed to disease-centred care. This approach is now viewed as not only desirable, but necessary, in addressing contemporary challenges for doctors and patients regarding areas such as the management and prevention of chronic disease. Communication is one of the keys to such challenges and being informed about the social nature of illness is a necessary part of the response. It looks likely that it is going to be tougher to slot into the system once medical training has finished in the future. A critical understanding of medical work will better prepare junior doctors for the challenges ahead of them. This book is a good place to start.