 Medical education and practice on the periphery: Consultation psychiatry and the psychosocial tradition in American medicineThomas M. Johnson Social Science & Medicine, 1986, vol. 22, issue 9, 963-971 Abstract: The culture of American medicine has both central biomedical and peripheral psychosocial traditions, a pluralism which demands further study. Anthropologists have traditionally learned a great deal about any culture by studying the socialization process, and the same is true of medicine. In consultation-liaison psychiatry, the peripheral position of the psychosocial tradition can be better understood as psychiatrists teach students and residents how to assist biomedical specialists in the care of their hospitalized patients. Through such student socialization, the use of the technology of biomedicine by psychiatrists for both the manifest function of patient care and the latent function of cementing interprofessional relationships is revealed. In consultation psychiatry, students are also taught that the object of their ministrations is not the patient, but all members of the ward milieu, a focus which is not characteristic of the biomedical tradition. Students in consultation psychiatry are inculcated with attitudes and values which are divergent from those of the biomedical tradition; the competetive presentation and selective assimilation of such elements of professional ideology by students further betrays the peripheral position of psychosocial concerns in medicine. This position is also highlighted by the teaching of 'survival strategies' to students and residents in psychiatry, designed to increase the likelihood of acceptance by biomedical specialists. These include mimicking biomedical approaches to diagnosis and treatment, viewing biomedical specialists as patients who are unwitting victims who can be cured with the right treatment, manipulating symbols and using metaphors of biomedicine to affirm the basic kinship of all physicians, and otherwise promoting psychiatry as central to modern medicine. Yet, the psychosocial tradition, itself, is not homogeneous. Students in psychiatry are confronted with diverse role models: psychopharmacologists who risk the charge of reductionism from within their own ranks; consultant psychiatrists who view themselves as messianic within medicine; and other psychiatrists who so abhor the biomedical tradirion that they only practice psychotherapy with patients outside the hospital. Nevertheless, consultation-liaison psychiatry is a specialty which holds great promise for promoting the interaction and diffusion of ideas between the biomedical and psychosocial traditions; for the social scientist it is an important arena both for further study of the professional socialization of medical students and for documenting the struggle for professional dominance within the culture of medicine. Date: 1986 Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:22:y:1986:i:9:p:963-971 Ordering information: This journal article can be ordered from Access Statistics for this article Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian More articles in Social Science & Medicine from Elsevier |
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