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HSC210 Health Sociology: Hierarchy and Power in the Health System

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You are required to write an essay on the following topic:

Hierarchy and power are intrinsic to the current health care system in Australia. Discuss this statement by drawing on sociological theories and concepts. Discuss how this may impact on you as a health practitioner.

Answer:


Introduction

In the Australia’s medical care system, the hierarchy and power are essential factors in the provision of quality health services to both Australian and foreign patients. In Australia, the patients do visit the general practitioner upon falling ill. The general practitioner has the power and mandate to either give them a referral to a specialist or a nearby public health care facility (Willis, Reynolds, & Keleher, 2015). According to the World Health Organization, (WHO 2013b), “a health system refers to all the activities whose primary objective is to promote, restore and maintain health. Also, it included that “a good health system should offer better health services to all the patients, at the time of need and wherever the place they visit.” The Australia’s medical care system is a combination of both the public and the private healthcare providers; it also includes the healthcare settings, active and dormant participants, and the support mechanisms (Lopes, Carter, & Street, 2015). In this essay, I would focus on the organization of Australia’s health care system, discuss the sociological theories and concepts supporting the essence of hierarchy and power in a medical setting. Also, shall mention about the biomedical model which is a fundamental perspective and discuss the impact of the health care system on the health practitioner.

Sociological Theories and the Role of Perspectives

Sociology involves the study of the social life and the social problems in the human society. The understanding of sociology is essential as it focuses on the health practitioners regarding the social health factors and how such factors influence the health conditions of the patients. The sociological approaches applied in the analysis of the medical care system are known as perspectives. Several sociological and concepts have been advanced to focus on the health care systems (Moran, Steketee, & Marles, 2015). The social theory which was developed by the sociologist Robert focuses on all the social interventions that have the unintended consequences of the social actions. All the social actions in the health care system get a regular evaluation of the unintended outcomes that might be detrimental to the nursing care. In the healthcare setting, the theory seeks to encourage for the termination of the social actions with serious consequences on the provision of quality health care.

Similarly, the social theory of reality, which was developed in the 1960s by Peter and Thomas Luckmann, acted on basis of social sciences foundation. The theorists argued that in the real world regardless of the matter basis, the earth is made up of both the socially and the culturally legitimate ideologies, practices, and other things. For instance, the spread and outbreak of the H1N1 influenza virus got declared globally as a crisis and life endangering disease (Henslin, Possamai, POssamai-Inessedy, Marjoribanks, & Elder, 2015). Also, the deadly cancer disease got declared in the entire world as another life-threatening pandemic. The theory also applies to the health care system in Australia in which the private and public health facilities are involved. In such a case, if a deadly pandemic gets discovered in the private hospital laboratories, an alarm is raised and all the private and the public hospitals informed. Since the hierarchy and power system also includes the local, state and national governments of Australia, gets alerted.

Additionally, there is the social theory which focuses on the social suffering and offers a platform which consists of the four potential global health insinuations. First, is the socioeconomic and the sociopolitical forces which may result in disease-causing agents at times (Payne, 2015). For example, in situations of abject poverty lead to structural violence which creates favorable conditions for tuberculosis to spread and the dire need for antibiotic resistance to be developed. Secondly, the bureaucracies of health care institutions which are set up to handle the suffering may make it worse. Examples include the medical errors or the failure to offer the accurate medical diagnostics. Furthermore, the social suffering establishes an idea that not only the patients suffers the pain of the disorder, but also it extends to the immediate family members and the entire social network (Gabe & Monaghan, 2013).

The family members more so the children may get frustrated experience the profound loss and discomfort. In the Australian health care system, there is need to offer health interventions to the family and the social network of the patient. For instance, the system should get some professionals such as psychologists to provide psychosocial support and nursing care specialists to offer patient education. Lastly, the theory breaks down the distinction involving what the difference between the health and the social problem (Birkland, 2014). The theory differentiates the two based on the health and the social policies which include; poverty struck families in the slums and the shanty towns, the broken families and also the areas that are prone to violence incidences which are settings for depressions, suicidal acts, the post-traumatic stress disorder and drug abuse addicts. In the Australian health system, there should be agencies or organs specialized in stress management and offering general guidance on the broken and poverty struck families. The families should get hopes for a better tomorrow, and the health system should organize free clinics to provide health care services to the residents.

Moreover, there exists the Biopower concept.  The Biopower terminology was forged by Michel Foucault as he tried to explain on the process of modeling the manner in which the governing political class excessively build pressure through setting regulations which organizations and the people would work under. The statistical research conducted in the Europe displayed the government’s efforts to conduct census with an aim of taking the control of the social factors, even though the government’s efforts had positive impacts on the health system (Cisney & Morar, 2015). Furthermore, the era of the radical collectivization during the Maoist policies in the government China during the 1960s and early 1970s. During this time, the human population control rule resulted to local cadres that required the local young women to write their menstrual cycle dates on the doors of their residential areas to act as a form of birth control and surveillance.  

The UN system and her agencies including the individual countries or states do frequently govern through the biopower such that the global health care programs shall end up serving the ulterior purposes. For instance, in the past conflicting nations, for example, Liberia and Sierra Leone, their government ruling is dominantly controlled by the UN system agencies and the Non-Governmental Organizations which ensures that there is controlled politics and improved social life through their programs with aims to reduce trauma and set up rehabilitation centres for the affected (Healy, 2014). The biopower concept emerges to be rapidly a vital factor in the world health programs that are being improved on by the nations. Consequently, the current Australian health care system should apply the Biopower concept in the health care management of the patients.

The Biomedical Model

The model is the fundamental perspective or sociological analysis approach that views health regarding biological processes amongst individuals. The biomedical model of health is attributed to the significant role of the biological determinants and seeks to explain the disease as the condition that gets caused by the external pathogens or the functional organ and the body systems disorders (Thomas, Menon, Boruff, Rodriguez, & Amhed, 2014).  The sociological approach has the factual verification and has proven the effectiveness in the prevention of widespread infectious diseases. The expansion and increased use of the biomedical approach and dire need for equal distribution of the necessity for the psychosocial factors that have led to an immediate improvement of the medical treatment efficiency and improved disease control mechanisms. All this happens in collaboration with the strong therapeutic relationships between the health care providers and the patients.

The perspective got applied in the clinical setting and research in the determination of the causal agents of certain diseases and the factors that contribute to the spread of such diseases (Ishikawa, Hashimoto, & Kiuchi, 2013). For instance, the biomedical approach got applied in the healthcare setting in identifying the conditions which are as result of an injury. The injury that causes diseases may have an external or an internal origin. The external causes got categorized into physical, the chemical and the microbiologic. While the internal causative agents get divided into three larger categories, which include; the vascular, immunologic and the metabolic category. Through the application of the biomedical approach to the clinical practice and research, there would be high chances for better health care services provision and customer satisfaction. This would be advantageous in ensuring patient safety and hastening the healing process.

The biomedical model developed in the medical practice as a piece of equipment for the rationalization and the surveillance of the human population. The perspective had four main assumptions. The assumptions include the disease’s germ theory. Secondly, the mind and the body separation assumption. Finally, the assumptions of the patient as a sick body, and the believe that the treatment of the patient lies in the hands of the trained specialist who was capable of diagnosing the patient through the use of medical equipment such as x-ray machines (Hatch & Cunliffe, 2013). The increased use of the model got connected with the transformation from traditional to modern technology and the revolutionization of science. The rise of nation-states has brought the idea of the population control by the economic and the scarce military resources. Furthermore, the Foucault has influenced the view that modernizing the medical field as a way of regulating and instilling discipline to both the individual human bodies and the social body.

Hierarchy and Power in the Health Care Setting

Hierarchy refers to the ranking in an organization such as in a medical center. In the Australia’s health care system, it is known to be a collaboration of private and public healthcare providers, settings, the participants and all the health supporting mechanisms. The healthcare providers do rank from the medical practitioners, registered and enrolled nurses, the allied professionals, the public and private hospitals and clinics, and the government and the Non-Governmental agencies. All the stated agencies offer different health services cutting across many areas, ranging from the public health and the control services in the immediate local community to the primary health care, the emergency medical services, on admission to the hospital services (Lopes, Carter, & Street, 2015).

Also, the health care providers offer rehabilitation and the patient-centered care. In the Australian health system, the public sector provides health services through the different levels of the government such as the local, the territory and the National government. The private sectors deliver its health care services via the help of the private hospitals, clinics, medical practitioners, and pharmacies. Regardless, the fact that public hospitals get funds from all the levels of government, the institutions are managed and run by the state and the territory governments. The private sector controls and runs the private health centers.

The government of Australia will tend to apply some sociological theories that were introduced by different theorists in the control of her population growth rate and improve the health care services provision. The government may choose to apply the social theory which focuses on how social suffering amongst the citizens acts as a potential causative agent for the spread of risk diseases. Such suffering can be through the abject poverty status, suicidal incidences, and depressions. The government shall adopt the social theory since the theory elaborates on what the government should do to rescue the lives of her citizens who tied under the chains of poverty in the slums and shanty shelters (Lindsey, 2015).

Impacts of Hierarchy and Power

Through the ranking, as a health practitioner, I shall be privileged to handle particular patients as per my ranking, and this would lead to quality services delivery. Patients would get the satisfaction of their needs since, as a practitioner, I shall have adequate time to research on the patient’s problems and deliver the most appropriate services (Gabe & Monaghan, 2013). Also, through the biomedical model understanding, as a practitioner, I shall get a better way of unearthing patient’s problems through revolutionized technology and better surveillance of the patient’s symptoms.

Conclusion

It is evident from the discussion that through the sociological theories and concepts there are positive findings that if implemented would improve the health care services provided by hospitals under the control and management of the state and territory governments. Some of the sociological theories and concepts include the social theory and the Biopower concept. The biomedical model in the health setting plays a significant role in its focus on the patient bodies and the diseases rather than the people in the immediate surrounding. The Biomedical has dominated the health care centers since it acts as a tool for knowing the determinants for a disease and rationalization of the surveilled population. The model has four assumptions. First, the germ theory concerning a disease.  The second assumption held that the body is separable from the mind. The third assumption rendered the patient’s body as sick and not the patient, but the body. Lastly, the effective treatment relies on the specialist who has had an opportunity to examine the patient’s body via electronic equipment such as the x-ray. The hierarchy and power show how the healthcare setting gets organized and how they get funding. Furthermore, through the hierarchy the way health care centers provide their health services has been outlined and also, the healthcare providers enlisted as per the role played.

References

Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the Australian health care system. Elsevier Health Sciences.

Lopes, E., Carter, D., & Street, J. (2015). Power relations and contrasting conceptions of evidence in patient-involvement processes used to inform health funding decisions in Australia. Social Science & Medicine, 135, 84-91.

Moran, M., Steketee, C., & Marles, K. (2015). Health LEADS Australia and interprofessional education. Leadership and Collaboration: Further Developments for Interprofessional Education, 182.

Henslin, J. M., Possamai, A. M., Possamai-Inesedy, A. L., Marjoribanks, T., & Elder, K. (2015). Sociology: A down to earth approach. Pearson Higher Education AU.

Payne, M. (2015). Modern social work theory. Oxford University Press.

Gabe, J., & Monaghan, L. (2013). Key concepts in medical sociology. Sage.

Birkland, T. A. (2014). An introduction to the policy process: Theories, concepts and models of public policy making. Routledge.

Cisney, V. W., & Morar, N. (Eds.). (2015). Biopower: Foucault and beyond. University of Chicago Press.

Healy, K. (2014). Social work theories in context: Creating frameworks for practice. Palgrave Macmillan.

Thomas, A., Menon, A., Boruff, J., Rodriguez, A. M., & Ahmed, S. (2014). Applications of social constructivist learning theories in knowledge translation for healthcare professionals: a scoping review. Implementation Science, 9(1), 54.

Ishikawa, H., Hashimoto, H., & Kiuchi, T. (2013). The evolving concept of “patient-centeredness” in patient–physician communication research. Social Science & Medicine, 96, 147-153.

Hatch, M. J., & Cunliffe, A. L. (2013). Organization theory: modern, symbolic and postmodern perspectives. Oxford university press.

Lindsey, L. L. (2015). Gender roles: A sociological perspective. Routledge.

Lopes, E., Carter, D., & Street, J. (2015). Power relations and contrasting conceptions of evidence in patient-involvement processes used to inform health funding decisions in Australia. Social Science & Medicine, 135, 84-91.

Barnes, B. (2014). Interests and the Growth of Knowledge (RLE Social Theory). Routledge.

Lopes, E., Carter, D., & Street, J. (2015). Power relations and contrasting conceptions of evidence in patient-involvement processes used to inform health funding decisions in Australia. Social Science & Medicine, 135, 84-91.

Rosen, B., Waitzberg, R., & Merkur, S. (2015). Israel: Health system review.

Kelaher, M., Sabanovic, H., La Brooy, C., Lock, M., Lusher, D., & Brown, L. (2014). Does more equitable governance lead to more equitable health care? A case study based on the implementation of health reform in Aboriginal health Australia. Social Science & Medicine, 123, 278-286.

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