By: Margaret Reid
Discussion Papers in Social Research No 13, University of Glasgow, 1976
©Margaret Reid - Reproduced with permission of the author
Within the last decade, the area of medical sociology has been fast growing. An increasing recognition of the importance of ‘social’ factors associated with various illness states has ensured medical sociology a continuing place in teaching and research endeavours. Yet teaching to whom? and research for whom? As an area of expertise supplementary to existing medical knowledge the status of medical sociology is assured, yet interestingly, as a branch of sociology, its position is ambiguous; the academic community only recently indicated acceptance of the research carried out under the heading of medical sociology. This paper charts the development of medical sociology from its entrance into British universities in the ‘forties until the present day.
Following the Goodenough report in 1944, (1) sociology and the other social sciences were introduced into the medical curriculum as disciplines worthy of medical attention. A new era began - the era of the social importance of man. Although sociology had had standing in the academic community in other countries for several decades (e.g. Germany, America), in Britain it had progressed little since the work of the Webbs and other sociologists of the early nineteen hundreds. The Goodenough Report, however, provided an impetus to employing British sociologists in a research capacity in medical settings. Thus there was a slow acceptance of sociologists in departments of social medicine, and much later, in the wake of the Todd report (1968) (2) the introduction of medical sociology in the undergraduate medical school curricula. Then followed a meteoric increase in sociologists in teaching posts and of research in that field. In 1969 a meeting convened at York brought together 50 researchers and teachers to form a new medical sociology subbranch of the British Sociological Association. The following year the group convener collated a research register which reported 65 medically related research projects. By 1973 it had become one of the largest groups of the BSA and meetings at York were now attended by over 300 people (3). l973 also marked the introduction of a house journal, the ‘Newsletter’. The second research register (1974) was more sophisticated than the first, documenting 183 research projects (4) in great detail and noting funding bodies, previous publications of members and so on. Perhaps medical sociology may be seen to have finally gained academic acceptance in sociological circles when the annual conference of the BSA takes for its 1976 theme ‘the Sociology of Health and Illness’.
From a historical perspective one gains a picture of a group of sociologists finding increasing respectability within two very different spheres - that of academic sociology, and that of medicine. While this statement has a bland truth, the reader is given no idea of the internal changes which took place within the group, or of the direction of the research accomplishment. Tracing the changes which took place within medical sociology is not merely an exercise in academic history, it also provides an illustration of the process of the ‘professionalising’ of a group.
The relationship which the sociologist forms with his employer or funding body affects the type of problem; he may he asked to tackle and, indirectly, the advancement of sociological theory. It is relevent to ask, for example, whether the sociologist is researching problems in which the employer feels sociology has a part to play (and thus allowing the employer’s perception of sociology to shape the direction of the research), and, in this situation, whether the researcher is under pressure to apply existing knowledge to the solution of the problem rather than to extend theoretical boundaries (although one can do both; See for example, the work of Merton (5). In studying any one branch of sociology one is setting up explanations as to why the discipline developed as it did, why certain interests were cultivated, others neglected. To understand the development of medical sociology, we begin by focusing attention on the Departments of Social Medicine, which were first to play host to sociology in a medical context.
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The introduction of sociology as an adjunct to existing medical knowledge can be best understood in the light of a general shift of social explanation. From the very individualistic orientation of the previous century came the new socialism of the nineteen hundreds, and an increasing tendency to assign ‘social’ explanations for behaviour. Deviant behaviour, for example, was no longer seen as resulting from the individual ‘criminal mentality’. Instead, an explanation was cast in the rhetoric of a social structure in which the distribution of material goods was unequal.
In medicine, ‘social explanations’ of the aetiology of disease meant for some doctors a redirection of medical thought from the purely clinical and psychological criteria of illness. The introduction of ‘social’ factors into medical explanation vas most strongly evidenced in branches of medicine closely related to the community — Social Medicine and, later, General Practice. Since its inception as the public health movement of the nineteenth century, social medicine had strong links with the problems of urban living, tending to seek so1utions in social and political action rather than in recourse to the laboratory. The socialists of the turn of the century focused their attention on the ‘social’ problems of the day — problems manifest through urban living, problems of drains and stairs, infectious diseases of industrial pollution.
This emphasis in the work of public health continued for three decades. In 1939, however, the continuation of that branch of medicine along previously established lines was challenged in a report to Oxford University.(6) In the report, the professor of Public Health at Oxford suggested that there should be a shift in emphasis from sanitation and the control of infectious diseases to work which would foster the synthesis of the medical and the social sciences. Largely as a result of this report, the first chair of Social Medicine was founded in Oxford, along with the Institute of Medicine, with the influential figure of Professor Ryle as director and first professor of Social Medicine. At that time, social sciences were identified as having ‘humanitarian and utilitarian motives’ which fitted in with the emphasis of Social Medicine on social and political solutions to social problems. Sociology as such was not taught as it was still in embryonic form as a discipline (although the Goodenough report, published in 1944, opened up the curricula of Public Health Departments, and laid the foundations for teaching in the social sciences). In its second year, however, Professor Ryle was able to report that the Institute carried out not only clinical and somatometric, statistical, and radiographic research but also sociological work.
What was studied under this last heading? ‘Social’ conditions which affected health and illness constituted the main interest, an exercise mainly in collecting statistics to find correlations between factors. For example, research from the Oxford Institute was the first to highlight the importance of poverty and overcrowding as causal factors in tuberculosis. Other research in the field concentrated on nutrition and infant mortality, antenatal care, child life and maternity.
Into this hive of research activity the sociologist was introduced, and was to participate for the next thirty years. Here, sociologists undertook research along the lines already mentioned, tackling issues problematic to the medical profession. The relationship of researcher to medical members of the Department was unequal from the beginning, doctors having status, resources and a strong professional identity in their favour. The medical perception of sociology exerted a strong influence upon sociologists which reached beyond the confines of the Social Medicine Departments. For example, at the first meeting of the British Sociological Association in 1953 three topics were chosen for group discussion; (7) these were:
- health
- design and planning - building, towns and countryside
- needs and standards in the social services.
Of the seven speakers on health, five were doctors (four with a qualification in public health), one speaker was a chief research worker of the Acton Society Trust, and the seventh was Richard Titmuss Professor of Social Administration at LSE. At the Conference, sociologists were asked to define social causes and social factors which were seen (by those medically qualified) as playing an important part in illness.
"It was said at one point in the discussion that the doctors were doing what was expected of them - but that social scientists were not. The questions which it was thought the latter ought to be answering emerged pretty clearly, ... There were first the social causes of ill health and the social conditions and behaviour conducive to good health. The second point of interest was the question of doctor-patient relations…. It was suggested that social scientists could throw light on the therapeutic effects of we1l-conducted human relations between giver and receiver of services, to the medical and of other kinds". (p. 203).
It is interesting to quote the response of the social scientists to the challenge made by the doctors. As reported by T.H. Marshall, there ‘was ‘alarm at the demands made on them’. Three difficulties were defined as putting them at a disadvantage as compared with the doctors. These were:
‘They did not have the same easy access to the persons they wished to study. The science of sociology had not yet developed an adequate body of theory. And, before they could apply such theory as they possessed, they must become thoroughly acquainted with the special circumstances in which their problem had its setting; they might go badly astray unless they acquired some knowledge of medicine’ (p. 204).
Marshall concluded by making a plea for pure research - ‘outside the stresses and strains of the ‘world of policy - making and administration’. Beholden to the doctors for access and understanding of certain medical situations, one might understand the request of the sociologists at the conference as one for greater autonomy. For there was a growing recognition that a discrepancy existed between the medical definition of sociology (and what it could offer in theory and understanding to the profession) and sociology as perceived by sociologists - a discipline ‘with potential as yet little realised. This discrepancy still exists today. Indeed, the supposition that these two disciplines - social medicine and sociology - could work together is perhaps more questionable today, since socio1ogical research has expanded its territories to include new theory and new method. But one could argue that this partnership was unstable from the beginning.
For the linking of sociology with social medicine is based upon two assumptions. First, both are looking for social explanations of behaviour, and second, use a methodology which assumes a scientific approach - for this is the respectable paradigm in the ‘medical sciences'. While these assumptions of common ground might have held true in the earlier years of British sociology, it is argued that they may now be shaky and one may reasonably question the continuing relevance of sociology as perceived by the medical profession.
To begin with, the term ‘social’ is notoriously vague and all-embracing; Durkheim notes: (8)
"the designation ‘social’ is used for its little precision. It is currently employed for practically all phenomena generally diffused within society, however small their social interest. But on this basis, there are, as it were, no human events that may not he called social" (p.1).
Thirty years later Wright-Mills skilfully unraveled at least four different meanings of the term ‘social’ to be found in social ‘work theory (9), while Marshall takes a similar standpoint: "it may be said that all policy, in that it is concerned with the actions of men in society is ‘social’. But it does not follow that all investigations ‘which have a bearing on policy are tasks for the social scientists (10) (p.207/8). To say that disciplines are seeking ‘social’ explanations obscures the ‘wide range of meaning of the ‘word, and ultimately, the varying orientations towards the study of man.
In medicine a ‘social’ diagnosis involves ‘social’ evidence about the patient and his family. Writing about social diagnosis, a professor of social medicine elahorates: (11) "that is, the relevant factors about his personal and family history and the environment as actually seen on a visit". Macintosh continues: ‘These two, when taken together, give a picture of your patient in relation to the problem to be studied: :illness, maladjustment, bad housing, the problems raised by the arrival of a new baby, the difficulties to be faced with a mentally defective child and so on (p. 54). These form the social factors to ‘be reckoned with, to be joined by pollution and poverty as ‘social problems’. They are social problems in as much as they are problems of large numbers of people and arise out of the organisation of society. Yet from the medical viewpoint society may be seen as only an intermediate link in the search to isolate the biological mechanisms.
On the other hand, a sociologist ‘would take a ‘social’ explanation to mean something rather different. Fo1lowing Rex’s argument, a social explanation must refer to the social relationships ‘which exist between men; (12) mere facts about the objective characteristics of individuals tell us nothing of any significance’. The term social relations implies the interactive nature of human behaviour, and incorporates notions of the symbolic order ‘which exists in society.
Thus a social explanation - in the sociological sense - of delinquency might incorporate social stereotypes held in society, and especially defining agencies like the police, prison officers, as well as behaviour expected by teenage peer groups, and so on. Housing, and poverty, are seen only as tokens of the symbolic order. Thus medical and sociological explanations cut across each other, each ignoring features of the everyday world which to tire other have considerable significance.
Methodologically, too, the two disciplines are far apart. Social medicine is linked to the logic of epidemiology and as most medicine, pays homage to scientific respectability. Sociology, however, draws upon a wide variety of research methods, and a key debate revolves around the scientific status of the discipline. Unlike medicine generally, epidemiology is based upon the study of groups, rather than the individual. Its methodology consists in finding statistical correlations between several variables, using the accepted procedures of control groups, experiments and intervention. Prevalence and incidence are key measures.
Thus the empiricist school of sociology - essentially the ‘abstracted empiricism’ of the nineteen fifties - appealed to the medical mind, for its methodology is moulded upon similar assumptions as that of public health. Morris, speaking at the BSA Conference, emphasised at the time: "I have no doubt myself that sociology needs to become, with biology and natural science, the third basic science in medicine" (p.208).
Whilst sociology has developed considerably, both theoretically and methodologically, in the last twenty years, however, the insistence upon empirical sociology continues today. Read in the Todd report, for example, the ‘object of instruction in sociology and related fields (14).
‘To introduce (the medical student) to the nature of sociological observation and analysis, to the nature of sociological theories about the rules governing group behaviour, and to empirical research designed to test such theories this will demonstrate that human behaviour and social institutions can be investigated by the established methods of science (my emphasis).
Yet to stress this one approach to sociological research ignores the other valid methods of sociological enquiry, and much of the rich data highlighted by these alternative perspectives. Interviews, observations, health diaries, socio-linguistic analysis and unobtrusive measures have all contributed to the development of sociological thought.
Through observational studies, for example, more detailed information of professional/client interaction has been gathered. Research suggests the complex negotiation which takes place when doctor and patient meet, the expectations each hold of the other, and the manner in which a successful outcome to the consultation is accomplished.(15) The categories arrived at through this kind of research are theoretical and qualitative rather than discreet and quantitative, nonetheless their contribution to sociological understanding is considerable.
To sum up, departments of Social Medicine, early hosts to sociologists working in medical settings, considerably influenced the direction of research; certain methods were approved as scientifically acceptable, while other features of lie sociological discipline were selectively neglected. But a wider array of factors have played a part in shaping the future of medical sociology. The comparative development of sociology in America, the context in which medicine continues to be practised in Britain, and the funding of such research have all contributed to the shape and form of current research. Each of these features is worth considering separately.
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In 1957 Strauss articulated a distinction ‘which ‘was to be much repeated in the following years - between sociology in medicine and sociology of medicine. The distinction lies in the orientation of the research.(16) The former applies the existing body of theoretical knowledge to solve medical problems, while in the latter case medical settings are used to illustrate and expand propositions of sociological theory. In America, medical sociological research developed along with the ‘health sciences and services’. Hollingshead, in his review of the field,(l7) stresses the collaborative relationship between the social and the medical sciences. This is perhaps not surprising given the early establishment of anthropology and sociology in America.
Talcott Parsons was one of the first sociologists to use medical settings as an example for his theory, devoting considerable energy to the discussion of the roles of physician and patient.(18) Ten years later medical sociology in America received further impetus from the introduction of a new methodology which related medicine strongly to the concerns of sociological theory and, as such, exemplified the sociology of medicine.
Work in the field of adult socialisation, for example ‘Boys in White’, a classic study of medical students passing through medical school, sparked off a new wave of interest in the process of socialisation.(19) In the field of the professions (again using the medical profession as one illustration,) researchers broke with the traditional approach by which new specialties emerge within professions. (20) Thus the new methodology of ‘grounded theory’, pioneered by Glaser and Strauss, (21) was especially influential in medical sociology because of its use of medical institutions as a backdrop for many of its primary investigations.
However, while American medical sociology established a tradition of offering theoretical feedback, British sociology at that time was relatively unproductive. The emphasis lay, and in many ways still lies, on sociology in medicine. The key to this critical difference is not necessarily that sociologists in Britain continue to be employed in medical departments, but rather that their thinking has continued to be influenced by the ideology upon which the British health service was built. Thus medical sociologists have remained within the system of beliefs about the value of health which in the past have guided members of the medical profession and social policy makers. For one of the major differences between British and American health systems has been the development of a socialised health system in Britain.
The aims of the National Health service have their origins in the ‘social utilitarianism’ of the last century; the goals run concomitant with those of the reformists of that time. The health service was conceived as an essentia1ly benign institution, organised to offer a certain form of health care to the people of Britain. Its administration has always been complex, requiring continued efforts of social policy makers to attend to the problems of the recipients of the service. Just as medical/’social’ problems provided a focus for early sociological enterprise, the nature of policy decisions and the basis of decision-making also became a major field of enquiry. The move into the field of social policy was reciprocated, however, as a background in social policy proved an important career channel for many academics, some of whom later became influential sociologists (Professor Titmuss, for example, present at the first BSA Conference, became chairman of the Association during 1959-62). These powerful links ‘with medicine and social policy permeate medical sociology with what might be critically termed a ‘liberal reformist ideology’, and a firm belief in the progressive improvement of health and health services. Sociological problems, even outside the framework of a service commitment, remain firmly located within the medical care system operating in Britain, and research is oriented towards ‘making the health services work’.
Thus research focuses upon how clients fit into new types of medical organisation - such as day wards, new units for handicapped children or units for the elderly. The implicit aim of the research is to select out non-conformists, or simply to identify those features of the organisation which are the least successful. Such studies tend to focus upon features of the National Health Service which prove problematic to doctors. Doctor/hospital communication, the role of other health workers, or the implications of changing the medical curriculum for the specialties are all set against a backcloth of the viability of medical practice in Britain.
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Any comments about research should take into account the nature of the funding sources, and the pressure to produce certain kinds and level of discourse. Following the Rothschild Report, the emphasis has been on applied social science and, with the decrease in university research facilities, it seems likely that future proposals will be channeled through research units. In the 1974 ‘Register’ of research at least half the listed projects are funded either by the Medical Research Council or the Departmcnt of Health and Social Security (or its Scottish equivalent). Thus proposals coming under the heading of ‘medical sociology’ are in fact vetted by research bodies on which sociologists have little or no representation. Discussing the issue of funding Jefferys pointed out recently that medical sociology is not seen as fitting into any clear category.(22) While both social science and medical research councils con be equally appealed to, so too can they equally reject proposals as not central to their interests. That medical sociological research is not seen as clearly falling within the remit of the Social Science Research Council, however, indicates the ambiguous status of that branch of sociology and the research carried out under that name. Whilst the funding of projects with little medical relevance may prove difficult, research with obvious applicability to the medical profession is better represented. Thus research considering social class differences in, say, ‘illness behaviour’ is likely to be viewed more favourably than a study of cross-cultural differences in such behaviour.
The effects of funneling interests along certain lines is seen as limiting the theoretical output of medical sociology. Atkinson, ‘writing in the house journal, reflects: ‘It is sobering to ask oneself what contributions to sociological thought are coming out of the medical (sociology) group. Our impact and importance are certainly not in proportion with our numbers and level of activity’ (23): whilst Johnson elaborates upon this theme in a recent paper. (24) The above discussion suggests, too, that certain areas of health and illness have been ignored: that, in articulating a medical reality, sociologists have neglected other facets of man’s behaviour in relation to the organisation of his physical well-being. Two examples will illustrate that this is indeed the case. In a recent issue of the ‘Newsletter’, Waddington has argued for more historical research - work which would net necessarily help to change the present system, but would place the present system in context, into perspective.(25) How do we know, he asks, about the doctor/patient relationship in, say, the 16th or 19th centuries? How did medical men establish themselves in practice in the 19th century? He feels the lack of historical perspective ‘in part may derive from the pre-occupation of medical sociologists with their respectability vis-a-vis the medical profession’. Waddington continues; ‘the constant necessity to justify what they do may have driven medical sociologists to adopt criteria of relevance which have been drawn up by non-sociologists, i.e. by medical practitioners’. A close examination of the ‘Register’ further substantiates his argument. It reveals that among the approximately 180 research projects listed, only 3 take an historical perspective.
Women’s problems associated with health and illness, to take a further example, have been typically neglected by members of the medical profession. Sociologists, too, may be accused of taking a sexist stance, a lapse which Sheldrake attempts to atone for in his consideration of the possibility of a male menstrual cycle.(26) Research in this area does exist, however. In her study of requests made to the General Practitioner for termination of pregnancy, McIntyre brings out very clearly the selective manner in which doctors arrive at decisions of this kind, and the criteria which they deem important in making such assessments.(27) Work focusing upon childbirth and the transition to motherhood, both events dominated by medical theory and technology, promises to fill in our understanding of the management of medical situations. Other questions remain unanswered. The criteria of relevance applied to ‘male’ and ‘female’ illnesses, and the differential regard of male and female patients by members of the medical profession are both topics recognised but never seriously considered by sociologists.
Yet this kind of critical examination need not be seen only as empty theorising. Take the concept of ‘illness’ for example. ‘Health’ and ‘illness’ can he seen as a classification partly devised and maintained by members of the medical profession. Health is socially constructed. Criticising the sociologist’s tendency to set apart scientific ‘fact’ from other moral judgements, Freidson, an American sociologist, has argued that there is little necessity for sociologists to adopt the medical system of categorisation - unless of course they wish to practice medicine.(28) Taking up the idea of illness as a moral category, Sedgewick pursues the argument further. (29) Focusing on mental illness, he highlights the contrasting explanations of mental illness sought by the medical profession. Rather than siding with any particular school of thought, Sedgewick attempts to break down the conceptual barriers between mental and other kinds of illness, arguing that all illness, mental and physical, should be viewed on the some continuum, as moral judgements of natural events, as constructions by society. Sedgewick’s attempts to step outside the classificatory system of illnesu and health used by western medicine would be approved of by Dingwall, who also stresses the need to view critically our taken-for-granted world, (30) noting that all theories of illness should be regarded as of ‘equal status if not efficacy’.
Discussion along these lines can go far in helping health workers understand, and accept, the behaviour of different social groupings. Whilst middle class clients may operate with similar conceptions of illness to those held by the medical profession, other social classes may not wholly adopt the dominant view. Thus into ‘good’ health they may include phenomena such as smokers cough’, dental cares, obesity, or prolonged backache. This offers a rational explanation for their subsequent inaction, or non-presentation to the doctor, behaviour otherwise seen as reprehensible by many of the medical profession.
One further point should be raised in this connection. Knowledge is never neutral, but dependent upon the interpretation of the group who are the recipients of the information. Data about any class or group in society can be used for manipulative purposes. As research findings are more likely to be transmitted to the decision-makers (possibly the medical profession) rather than the research sample, it is easy to see how the sociologist becomes locked into the very system from which he is seeking autonomy.(31)
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Whilst research has been pursued for over two decades in Britain, teaching of medical sociology to students has only opened up as a possible career channel in the last ten years. It is now General Medical Council policy to include some sociology in the medical curriculum, and, in 1974, 52 medical faculties offered such courses to their students. Interestingly, a smaller number of sociology students find courses in medical sociology available to them. The increase of courses has encouraged publication of textbooks, an event which highlights the ambivalent orientation of medical sociology. Teaching to medical students still tends to adopt the ‘cook book’ approach criticised by McKinlay in 1971.(32) Skimming over a wide variety of substantive topics with little or no attempt to relate any of the subject areas to a. theoretical approach, textbooks offer a conception of sociology as a prolix narrative of an obvious world. This approach is hardly suitable for sociology students, with whom a far greater understanding of sociology can be assumed. Courses in the sociology of medicine should concentrate upon the organisations and social relations within health and illness. Few textbooks help with this approach at present. (Curiously epidemiology is sometimes included in courses for sociology students, an interesting reminder of medical influence in this field.)
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Should one end such a paper on a. hopeful note? In a seminal paper (written in 1974), Illsley proposes medical sociology as an independent specialism; it has gained, to borrow the title of his paper, ‘promotion to observer status’ within medicine. (33) He offers an optimistic picture of increasing likelihood of funding for sociological work, and of greater access to medical settings. One could look for further confirmation of this view to the medical sociology group, whose structure and work h. a changed considerably over the hot six years. Much of the research documented in the1970 Register is epidemiological, and over half the personnel involved were medically qualified. The ‘74 Register tells a different story, with the number of researchers based within sociology departments greatly increased. Medical representation is minimal.
Considering changes within medical sociology, one must also take into account the growing importance and professional strength of other health workers in the field of health and illness, for example, nurses social workers and health visitors. Perhaps as one aspect of ‘professionalising’, these groups have become more research conscious in the last few years, and many have looked to sociology to offer a theoretical framework on which to base their studies. The interest of other personnel in the field of health and illness also broadens the type of setting open to sociologists for investigation and widens the funding opportunities. Teaching of medical sociology in diplomas in social work, health visiting, and the like has brought the sociologist into contact with these groups, and debates are generally improved by the addition of alternative views about the organisation of health and illness. Further, within the context of the widening sphere of interest in, and of, medical sociology, the relationship changes between sociologist and members of the medical profession. The two way dialogue becomes an all-round discussion.
Much has been written about sociology and medicine. Perhaps one could interpret the continuing debate as conflict over the definition of medical sociology, and the nature of its contribution to medicine and sociology. Certainly members of the medical profession have done much to sponsor and encourage the development of sociology in medical settings. But to contribute to sociological theory in the way other substantive areas have exemplified, requires freedom to work outside the dominant influence of medical thought. This is doubly difficult, not only because of the control over resources held by the medical profession, but also because medical categories pervade our everyday language and life. Sociologists have to make decisions about with whom their allegiance should: lie, and in what ways they can best contribute to this group. It is hoped that by tracing the development of medical sociology its present position becomes easier to understand. Decisions about future work can then be advanced.
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1. Ministry of Health, (1944), Report of the Interdepartmental Committee on Medical Schools, (Goodenough Report), HMSO., London. Back to top.^
2. Royal Commission of Medical Education, (1966), Report of the Commission, (Todd Report), IHMSO, London. Back to top.^
3. Although the numbers at the annual Conference stand at about 300, only just over 100 are members of the British Sociological Association. This still makes the medical sociology group one of the largest. Back to top.^
4. Johnson, N. (ed), (1974), Medical Sociology in Britain, British Sociological Association Medical Sociology Group. It is appreciated that research documented in the registers is not necessarily representative of all medical sociological research. Back to top.^
5. See Merton; Chapter in Madge, J., (1962), The Origins of Scientific Sociology, Free Press of Glencoe, New York. Back to top.^
6. Massey, A., (ed), (1945), Modern Trends in Public Health, See especially: Crew, ,F.A.E., Social Medicine as an Academic Department. Also, Leff, S., (1953), Social Medicine, Routledge & Kegan Paul, London. Back to top.^
7. Marshall, T.H., (1953), Conference of the British Sociological .Association, 1953, British Journal of Sociology. Vol. IV, No.. 3, pp. 201-209. Back to top.^
8. Durkheim, E., (1964), Rules of Sociological Method, Glencoe, Free Press. Back to top.^
9. Wright-Mills, C. . The Professional Ideology of Social Pathologists, in Skipper, Lefton and McCaghy, (eds.), (1968). Appleton-Century Crofts, London. Back to top.^
10. Marshall, T.H., (1953), op..cit. Back to top.^
11. Macintosh, J.K. (1965), Topics in Public Health, Livingstone, Edinburgh and London. Back to top.^
12. Rex, J., (1970), Problems of Sociological Theory, Routledge & Kegan Paul, London. Back to top.^
13. Marshall, G.E., (1953), op..cit. Back to top.^
14. Royal Commission on Medical Education, (1966), op.cit. Back to top.^
15. For example, see Horobin,, G.. and Bloor, M.. Conflict and Conflict Resolution. in Cox, C.,and Mead, N., (1975), The Sociology of Medical Practice, Collier-Macmillan, London, and Stimson, G., and Webb, B., (1975), Going to See the Doctor, Routledge & Kegan Paul, London. Back to top.^
16. Straus, R., (1957), The Nature and Status of Medical Sociology, American Sociological Review, Vol. 22, No. 2, pp. 200-204. Back to top.^
17. Hollingshead, A.B., (1973), Medical Sociology: A Brief Review, Millbank Memorial Fund Quarterly, Health and Society, Fall, 1973. Back to top.^
18. Parsons, T. The Social System, (esp. Ch.10).Tavistock, London. Back to top.^
19. Becker, H.. et. al., (1961), Boys in White, University of Chicago Press, Chicago. Back to top.^
20. Strauss, A., et.al., (1964), Psychiatric Ideologies and Institutions, Free Press of Glencoe, New York. Back to top.^
21. Glaser, L.G. and Strauss, A.L., (1966), The Discovery of Grounded Theory, Wiedenfeld and Nicolson, London. Back to top.^
22. Jefferys, M., (1974), Newsletter of the Medical Sociology Group,. Vol 2. No I. Back to top.^
23. Atkinson, P., (l975), Newsletter of the Medical Sociology Group, Vol. 1 No. 3. Back to top.^
24. Johnson, M, (1975), Medical Sociology and Sociological Theory, Social Science and Medicine, Vol. 9, pp.. 227-232. Back to top.^
25. Waddington, 1, (1974), Newsletter of the Medical Sociology Group, Vol. 2, No. l. Back to top.^
26. Sheldrake, P., (1974), Medicine, Politics and Ideology,, paper presented at the National Deviancy Group/Medical Sociology Group Conference, Bath. Back to top.^
27. McIntyre, S., (1974) Who wants babies? Paper presented at BSA Annual Conference, forthcoming in Conference Volume. Back to top.^
28. Freidson, E, (1972), Profession of Medicine, Dodd Mead, New York. Back to top.^
29. Sedgewick, P., (1976), Illness - mental and otherwise. Forthcoming in book on ‘psychopolitics’, Harper and Row, London. Back to top.^
30. Dingwall, R., (1974). Conceptions of Illness, Unpublished paper. Back to top.^
31. For a good discussion of this point see Ch. 8 of Eldridge, J.E.T. aid Combie, A.D., (1974), A Sociology of Organisations, Allen and Unwin, London. Back to top.^
32. McKinlay, J.B., (1971), The concept, "patient career", as a heuristic device for making medical sociology relevant to medical students, Social Science and Medicine, Vol. 5, pp.. 441-460. Back to top.^
33. Illsley, R., (1975), Promotion to Observer Status, Social Science and Medicine, Vol. 9, No. 2. Back to top.^
Selected Bibliography of Published WorkIllsley, R. (1975) Promotion to observer status, Social Science and Medicine 9, 63-67.
Illsley, R. (1980) Professional or Public Health: Sociology in Health and Medicine. London: Nuffield Provincial Hospitals Trust (Rock Carling Monograph)
Payne, G. Payne, J. Dingwall, R. and Carter, M.P. (1981) Sociology and Social Research. London : Routledge and Kegan Paul. (especially chapter on Ethnography).
Stacey, M. (1981) Medical sociology and health policy: an historical overview. In J. Gabe, M. Calnan, and M. Bury (eds) The Sociology of the Health Service. London: Routledge.
Stacey, M. and Homans, H. (1978) The sociology of health and illness: its, present state, future prospects and potential for health research, Sociology 12(2): 281-307.
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