No longer a patient: The social construction of the medical consumer

Sulik, Gayle; Eich-Krohm, Astrid

doi:10.1016/s1057-6290(08)10002-x

Cited by 32 publications

(33 citation statements)

References 26 publications

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“…These include the rise in medical consumerism, the self-care movement, and the resurgence of holistic health in the 1970s [17, 18, 47, 48]. In addition, many physicians are more engaged with CAM practices and therapies than previously, which may explain some of the findings.…”

Section: Discussionmentioning

confidence: 99%

Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects

et al. 2017

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BackgroundThe use of complementary and alternative medicine (CAM) is growing. However the factors contributing to changes over time and to birth cohort differences in CAM use are not well understood.SettingWe used data from 10186 participants, who were aged 20–69 years at the first cycle of data collection in the longitudinal component of the Canadian National Population Health Survey (1994/95-2010/11). We examined chiropractic and other practitioner-based CAM use with a focus on five birth cohorts: pre-World War II (born 1925–1934); World War II (born 1935–1944); older baby boomers (born 1945–1954); younger baby boomers (born 1955–1964); and Gen Xers (born 1965–1974). The survey collected data every two years on predisposing (e.g., sex, education), enabling (e.g., income), behavior-related factors (e.g., obesity), need (e.g., chronic conditions), and use of conventional care (primary care and specialists).ResultsThe findings suggest that, at corresponding ages, more recent cohorts reported greater CAM (OR = 25.9, 95% CI: 20.0; 33.6 for Gen Xers vs. pre-World War) and chiropractic use than their predecessors (OR = 2.2, 95% CI: 1.7; 2.8 for Gen Xers vs. pre-World War). There was also a secular trend of increasing CAM use, but not chiropractic use, over time (period effect) across all ages. Factors associated with cohort differences were different for CAM and chiropractic use. Cohort differences in CAM use were partially related to a period effect of increasing CAM use over time across all ages while cohort differences in chiropractic use were related to the higher prevalence of chronic conditions among recent cohorts. The use of conventional care was positively related to greater CAM use (OR = 1.8, 95% CI: 1.6; 2.0) and chiropractic use (OR = 1.2, 95% CI: 1.1; 1.4) but did not contribute to changes over time or to cohort differences in CAM and chiropractic use.ConclusionThe higher CAM use over time and in recent cohorts could reflect how recent generations are approaching their healthcare needs by expanding conventional care to include CAM therapies and practice for treatment and health promotion. The findings also underscore the importance of doctors discussing CAM use with their patients.

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Section: Discussionmentioning

confidence: 99%

Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects

et al. 2017

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“…As a case in point, Into Our Own Hands (Morgen, 2002) chronicles the SHGs of women who learned about their bodies and appropriated the knowledge for women which culminated in the now-classic volume Our Bodies, Ourselves: A Book by and for Women (The Boston Women's Health Book Collective, 1971) which has become an icon of the women's health movement. Also see Chambré's (2006) discussion of SHGs and support groups for AIDS patients and Lerner's (2001) discussion of the SHG Recovery, Inc. for breast cancer (see Sulik & Eich-Krohm, 2008;Bourgeaultetal, 2008 in this volume for a critique of how national level social movements run the danger of incorporation and individualization by neo-liberal policy making and the established medical systems).…”

Section: National and Community Levels Of Social Change And Consumer mentioning

confidence: 99%

Self-help groups challenge health care systems in the US and UK

Borkman¹,

Munn‐Giddings²

Patients, Consumers and Civil Society

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PurposeThis research considers how self-help groups (SHGs) and self-help organizations (SHOs) contribute to consumerist trends in two different societies: United States and United Kingdom. How do the health care systems and the voluntary sectors affect the kinds of social changes that SHGs/SHOs make? Methodology/approachA review of research on the role of SHGs/SHOs in contributing to national health social movements in the UK and US was made. Case studies of the UK and the US compare the characteristics of their health care systems and their voluntary sector. Research reviews of two community level self-help groups in each country describe the kinds of social changes they made. FindingsThe research review verified that SHGs/SHOs contribute to national level health social movements for patient consumerism. The case studies showed that community level SHGs/SHOs successfully made the same social changes but on a smaller scale as the national movements, and the health care system affects the kinds of community changes made. Research limitationsA limited number of SHGs/SHOs within only two societies were studied. Additional SHGs/SHOs within a variety of societies need to be studied.

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“…At the centre of the model is the informed health consumer who assumes she/he has the right to make their own choices to buy treatment in a health care market which is another form of mass consumption. In so doing, they reflect on information about their condition and appropriate treatment drawn from a wide range of sources which include not only the formally approved outlets of science and state but also the burgeoning information banks of the internet (Sulik and Eich-Krohm, 2008). The latter has proved to be particularly important to consumers of stem cell therapies given that the advice of the national and transnational hegemonic institutions of biomedicine is hostile towards the stem cell therapy clinics consumers often want to access (see eg ISSCR, 2008a; Australian Stem Cell Centre, 2009).…”

Section: Consumer Demand and The Emerging Counter-hegemonymentioning

confidence: 99%

Hegemony in the marketplace of biomedical innovation: Consumer demand and stem cell science

Salter

Zhou

Burton

2015

Social Science & Medicine

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The global political economy of stem cell therapies is characterised by an established biomedical hegemony of expertise, governance and values in collision with an increasingly informed health consumer demand able to define and pursue its own interest. How does the hegemony then deal with the challenge from the consumer market and what does this tell us about its modus operandi? In developing a theoretical framework to answer these questions, the paper begins with an analysis of the nature of the hegemony of biomedical innovation in general, its close relationship with the research funding market, the current political modes of consumer incorporation, and the ideological role performed by bioethics as legitimating agency. Secondly, taking the case of stem cell innovation, it explores the hegemonic challenge posed by consumer demand working through the global practice based market of medical innovation, the response of the national and international institutions of science and their reassertion of the values of the orthodox model, and the supporting contribution of bioethics. Finally, the paper addresses the tensions within the hegemonic model of stem cell innovation between the key roles and values of scientist and clinician, the exacerbation of these tensions by the increasingly visible demands of health consumers, and the emergence of political compromise.

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No longer a patient: The social construction of the medical consumer

Cited by 32 publications

References 26 publications

Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects

Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects

Self-help groups challenge health care systems in the US and UK

Hegemony in the marketplace of biomedical innovation: Consumer demand and stem cell science

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