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This paper reviews the author's experience in becoming a medical sociologist before the field had become formalized. The contributions to medical sociology of sociologist Selden D. Bacon and physician and medical educator William R. Willard are described. The relationship of medical sociology to medical behavioral science, as experienced at the University of Kentucky, is discussed. Finally, the thesis of the author's 1957 paper on the nature and status of medical sociology is re-examined. [ABSTRACT FROM AUTHOR]

This paper addresses current contentions that medical sociology is handicapped as both a scholarly and a policy science by its subordinate relationship to the more powerful field of medicine. An analysis of all research articles published in the JOURNAL OF HEALTH AND SOCIAL BEHAVIOR which focus upon patients reveals the following: (1) the presence, in the majority, of implicit and explicit medical value assumptions influencing all stages of the research process, from the definition of problems and variables through the application of findings to health policy; (2) a tendency for cases of "medical bias" to be associated with collaborative research in which the sociologist is wholly or partly dependent upon medical sponsorship and definition of the research situation. Consequences of this situation for the human subjects of research as well as for the field are discussed. A conclusion is that both our subjects' interests and the theoretic and political integrity of the field are best served by maximizing professional autonomy vis-à-vis medicine. A proposal for studying the structure of working arrangements concludes the paper. [ABSTRACT FROM AUTHOR]

This paper examines the social construction of diagnosis and illness in several ways. First, I discuss the centrality of social construction in medical sociology. Next I discuss the major role of diagnosis in social construction, leading to the need for a sociology of diagnosis. I emphasize controversial and conflictual diagnoses, as a first step toward a more general sociology of diagnosis. Then I put forth a typology of social construction, involving four combinations based on whether a condition is generally accepted and whether a biomedical definition is applied. Next I detail a series of stages in the social construction of a condition. In that process, my primary concern is the initial social discovery, which is essentially a matter of diagnosis, with a secondary emphasis on illness experience. This is followed by stages of treatment and outcome, which recursively affect social construction. I conclude by noting the health policy implications of the social constructionist perspective. [ABSTRACT FROM AUTHOR]

This paper is a revision of the address given upon receipt of the Leo G. Reeder Award for distinguished Scholarship in Medical Sociology. It was presented on August 19, 1987 to the Medical Sociology Section of the American Sociological Association during its annual meeting held in Chicago. [ABSTRACT FROM AUTHOR]

In this thoughtful paper, Mechanic discusses the differences between quantitative and qualitative researchers, focusing on health-related issues. It should, of course, be evident to readers that the issues he discusses have applicability far beyond medical sociology. The same issues arise in all kinds of social research and the excellent examples he gives can be expanded easily to examples in areas including education, criminology, industrial relations, social stratification, and others. In my reading of his paper, Mechanic discusses both differences between methods at a single point in time and differences in measuring process across time. As a quantitative survey researcher, I will comment on my perceptions of the similarities and differences between observational and survey methods for cross-sectional research. I then discuss some methods for bridging the gap that do not involve diaries. Finally, I discuss procedures for measuring process using observational and diary methods. [ABSTRACT FROM AUTHOR]

The current situation in health care organizations, among providers and for people, dramatically challenges the "business as usual" roles of medicine, government, insurance companies, the community, and the university. Health care reform marks the first attempt in a century to consider a reconstruction of the social contract between society and medicine. While sociology stands as one of the earliest social sciences to systematically study the health care arena and create a health-focused subfield, there is a perception, not without support, of a desertion of identity from within, an encroachment by other areas from without, and abandonment by the parent discipline. We argue that these situations in medical arenas and in research fields require serious rethinking. The key lies in understanding how these phenomena are related to each other and to larger social forces, and how they offer opportunities, rather than signal limitations, to medical sociologists. We turn to the theoretical tools of sociology to help unravel the complicated challenges that face both policymakers and researchers. After framing these issues in a sociology of knowledge perspective, we use the case of "utilization theory" to illustrate the connections between society and systems of care (as well as studies of them) and to create a future agenda. We end by raising three basic questions: (1) Why is a sociological perspective critical to the understanding of change and reform in health care? (2) Why is medical sociology critical to the survival of the general sociological enterprise? and (3) Why is general sociology critical to the research agenda in medical sociology? [ABSTRACT FROM AUTHOR]

Why is it that quantitative and qualitative researchers on health issues often have divergent findings and conclusions? Exploration of such differences can be a useful way of bringing separate intellectual enclaves in medical sociology together and also can stimulate future inquiries. Some differences can be resolved by more precise definitions, by comparable frequency and timing of measurement, and by careful evaluation of meaning contexts. The triangulation of methods, using diaries as a bridge between surveys and qualitative measurement, offers particular promise. Improved theory on the relationships of method to data, and more attention to behavioral sequences and the social context of measurement, can serve as a stimulant to innovative solutions. [ABSTRACT FROM AUTHOR]

The emphasis of this analysis is on the social institutional history of medical sociology. This subfield is described as (1) closely connected with the patterns of development in its current discipline, (2) as containing a dual thrust between applied and basic science, and (3) as struggling with "insider-outsider" ambiguity involving the work of subgroups working either in medicine or from roles external to medicine but studying the sociology of medicine. Tracing a detailed historical fragment from the decade following World War II, it is predicted that the continuity of an accepted position for medical sociology is assured even though the style and quality of its professional life are full of uncertainty. [ABSTRACT FROM AUTHOR]