Illustration of Hierarchy and Power Using Sociological Theories

Question: Discuss about the Illustration of Hierarchy and Power Using Sociological Theories and Concept. Answer: Globally, Australia was ranked 6th in 2014 for its excellent healthcare service provision, which has brought about more benefits including improved life expectancy (Marchildon, 2013). Healthcare was provided by both private and public setting, but the administration is done in a federal government system. The introduction of mediocre systems occurred in 1984 where it entailed the universal provision of treatment services in public hospitals. The health sector in Australia has high inequality which brings about health differences within social groups (WHO, 2010). In health institutions, social hierarchy can be observed due to their class, education income, and the level of revenue. The description of power can be given in two broad descriptions; based on the one responsible for resource control as well as decision making, and one was accountable to manage ideas and give meaning (Mcdonald et al., 2012). Monitoring and power define a class, and it provides an indication of the relation of employment, together with the conditions in a healthcare system. In some cases, great power shows that the workers who are high in an organization benefit more at the expense of other's energy (Lowe et al., 2012). This provides clear proof that those at the bottom in the hierarchy are the most losers of power while receiving lesser pay (Marchildon, 2013). This essay seeks to bring about an understanding of how authority and power impact the healthcare service provision in Australia currently while paying a close reference to sociological theories and concept. Clinical officers and doctors may perceive the merited doctor who is their sole role model, and this case is similar to a scenario where the hybrid managers have a high power which is not what he or she is entitled to, rather than using his position power while dealing with the staff in the health set up (Blyund et al., 2012). While position power is becoming less efficient in the higher rank of the hierarchy, the departmental manager is ranked low regarding formal authority (Scambler, 2013). Disuse of position power brings about the difference in hospitals, due to inhibition of hierarchy of management by the departmental managers (Ivan et al., 2014). The hierarchy in a health set-up has placed surgeons at a high rank while the general practitioners are lower on the ladder. All other doctors are left unclassified and are somewhere at the center (Blyund et al., 2012). The pecking order of the doctors dictates how they intermingle and is indicated by their knowhow and experience. There is a great gap between a surgeon and an anesthetist, especially when looking at private health centers. Specialists believe those anesthetists are just there to facilitate the operation while they perform it just because they are their employee (Brown, 2013). There were many differences in the development of Australian government earlier where it had a little engagement to healthcare. In the 18th century, colonial settlement led to emergence and growth of hospital sector, and this was sponsored by the subscription fees (Marchildon, 2013). Treatment and other services offered by the doctors were done where there was a gap in providing these services hence making the wealthier to be favored. Religious institutions came up and ran with charity hospitals with the aim of helping the poor in treatment (Mcdonald et al., 2012). The contest by the government between the doctors made the practitioners in various organizations to compete, and their role was to manage admission and treatment of patients while those at the religious sector acted as Friendly Societies that had a role of administering the hospitals (Connell, 2012). In the case of illness in a wealthy and highly respected social class, treatment was administered at home, and this would g uarantee payment (Thompson et al., 2012). In early years there was a freedom that allowed doctors to admit private patients who were to pay the accommodation bills in charitable or in public hospitals, which gave room for gains for both the physicians and the hospital boards (Wuest, 2012). Later in Australia, there was the emergence of different hospital boards that had to report to the department of health or even commissions in hospitals. Due to increased taxation by the commonwealth, the charges increased detrimentally (Thompson et al., 2012). In late 19th and early 20th century, Commonwealth reduced its involvement. Changes were observed later in 1921 when Federal health department was created and took the mandate of health service provision together with the states. Commonwealth was then given more powers in formulating the health policy, and it became predominant in issues about policies of physicians and pharmaceuticals. Australian states took the direct involvement in healthcare provision and had a significant role i n the hospitals (Thompson et al., 2012). Gray (1991) argues that early hospitals were funded in a manner that was an inchoate mix of contribution by well-wishers. At the beginning of the 20th-century, free care for all was campaigned for by the labor party when they created nationalized hospitals in Australia. Abandonment of regional health authorities occurred in Western Australia and Tasmania eight years after state-level consolidation. Southern Australia had a Generation Health Review moved towards a system review based in Adelaide (Willis et al., 2016). It was noted that Australia has a high mode of centralization regarding decision making which is more concentrated at the state level as it is given a great intervention by Commonwealth governance (Marchildon, 2013). An overview of conflict theory indicates that stratification is very dangerous in the current state of health care sector of Australia (Scambler, 2013). This is because the less fortunate have less power while those who are at the top of the hierarchy are becoming more powerful. In the US there is unequal access to medical care where the disadvantaged ones include the aged women, poor, and the minorities (Shephered Zubrick, 2012). A routine of winning is maintained by highly ranked people at the expense of the less recognized in the health institution. The example of a surgeon and an anesthetist can be a perfect one because the doctor believes that an anesthetist is his employee whose work is to enable the operation to be a success. Also, nurses have no power to give orders, yet they must act as the check while concluding everything the doctor have made and are ready to rectify any omission (Connell, 2012). In conjunction to this, a live example has been given where chemotherapy was to be intravenously given to a patient, and the order was stated with the formula which aimed at brain delivery. In actual sense, this could bring about the significant error in dosing depending on the kind of drug prescribed. This refers that, if the doctors and nurses don't strive to work together, there will be thousand fold of dosing error which is avoidable in a well-organized health care sector (Bryant Jerry 2014). In the situation of mistakes, there is ease for the intrepid nurse to be fired. Conflict theory brings to the light the wrong ways of bringing the wealth to the society. Criticism has been expressed by different functionalists in their argument that various parties should not work expecting self-gain or interest. Also, the conflict theorists bring about the stagnation of people in making progress, especially in the health sector due to personal power (Scambler, 2013). Functionalism is another theory that explains the purpose, both positive and negative in an institution. Stability and togetherness of the society are created by the positive goal which in this case is preventing and suppressing the disease in case of its occurrence (Craib, 2015). In this regard, people of all dignities including age, class, race, or even gender should be considered and treated equally (Morgan, 2014). Contrary purpose leads to instability and scattered community. Also, there is a need for a symbolic interaction to explain the management and interaction of the physician and his patients especially in the case of a male gynecologist and a female patient (Wuest, 2012). The examination has to be strictly impersonal. Several social institutions are related to each other in a systematic way such that, health care facilities works in conjunction with the government in various ways that include the federal regulation that deals with the release of new drug procedure. Another involvement of government in the health sector is in scientific institutes such as National Institute of Health which deals with funding for research that is based on health administration and policy (Bryant Jerry 2014). Also, the healthcare sector has led to income generation due to various work position available where many people are employed in Australia. Ideally, the primary role of functionalist theory of sociology tries to explain how health care sector differs from other forms of the institution and how this may be vital to the whole society of Australia (Wuest, 2012). Another theory that explores hierarchy and power in healthcare is Marxists, which states that there is need for material to be gained by human beings. Marx believes that basic necessities include food, shelter, and cloth (Coburn, 2015). According to him, the origin of various diseases is related to social constraints in such a way that they are influenced by the system of capitalist economy. Regarding capitalist society, the medical profession service provision results from business interest (Cockerham, 2014). This approach ascertains that there is power in a health profession that results from an alliance in the center of occupation and that of power macro-level structures. The hierarchy depicted under the concept of capitalism is of four levels where the first tier is financial, industrial, capitalist state medicine is the third one while the last one being a public state (Britt et al., 2013). In this scenario, the first state is the most influencing level, while the capital and th e capitalists are the drivers of medicine while the public is viewed as a challenge. The occurrence of capitalism with technology in medicine brings about more acquisition in nature that is similar to the orthodox model used by a health professional (Thompson et al., 2012). The solution caused by Marxists theory includes finding out the people or organization responsible for formulating the health agendas related to health and the roles played. There is a need to find the gainers and losers of a certain list in the global economy, the resources located in the public sector, the kind of health research being undertaken and lastly the distribution of power within the healthcare institution. This theory argues that there is poverty that is linked to how healthy an individual may appear in that, the people who are materially wealthy are less prone to become ill while those lacking have a higher probability of becoming sick. This is because the view of a capitalist society is investing i n an enterprise that will bring more gain to the society and hence high profit is maintained (Marsland, 2014). Marx suggests that being in the medical profession is voluntary and the service provided should be more quality since it is done by diagnosing the cause of the problem and coming up with the ultimate solution. The purpose of health providers is to ensure that patients health is maintained and that they become more economically productive (Coburn, 2015). Another concept is concerning symbolic interactionism where there is belief that sickness is part of social constructs. According to Travers (2001), the symbol can have the various meaning given by the mode of people's living. This can be expressed in many forms including dressing code, speech, and actions. There are two types of patients according to ancient view of the United Kingdom, those considered deviant and the category of sick people. The sick are given a higher percentage of sympathy as compared to the deviant (Wuest, 2012). For example, we can take a drunken person who was considered to lack the moral fortitude and therefore deviants during the prohibition era in America (Lowe et al., 2012). Currently, alcoholism is considered as an illness that can be diagnosed and treated depending on the labeled level of abuse (Cockerham, 2014). Also, symbolic interaction defines various roles that are played by the healthcare providers, where there is a hierarchy that gives the medical doctors a top rank while their assistants, the nurses, and the orderlies at the bottom in this ladder. The patients have to abide by the rules of how the administration of the treatment will be achieved while the pharmaceuticals and insurance are there to contribute in medical care provision by administering drugs and financial cover. This theory defines the role of various players in a hospital setting where there are healthcare providers, patients, and other stakeholders. The labeling of disease and its treatment in the current world is also a symbolic interaction (Wuest, 2012). Max Weber and George Simmel dug deep to find the roots of social interaction theory back in the history which gave a shape to earliest qualitative research related to healthcare (Cockerham, 2014). Weber explained that there is a meaning for the social action being undertaken individually, which reflects the health professionals that was aimed at bringing physician regulations to go hand in hand with that of the United Kingdom. The social class in which an individual fit has a direct impact on the health services available. Jacob Merone (2004) stated that health greatly depends on how wealthy a person is, such that the richer and those with high social class have a long life (Snyder Deaux, 2012). The lower social class will lead to less access to Medicare (Craib, 2015). The wealthier tend to rate their health as more improved in comparison to those having less income. Those having lower social class may experience a high incidence of neonate mortality, experience stillbirth, cardiac a rrest or even tuberculosis. These and other illnesses may be triggered by ones mode of living and social class (Wuest, 2012). People living in a low socioeconomic status may tend to smoke more, and this is known to be the major contributor to the lung cancer illness and some extent occurrence of cardiovascular disease (Cockerham, 2014). Hierarchy and power in health care can impact my career as a medical practitioner. This is because varying education levels and occupation guides the level in which a medical PR actioner will be placed. There are different employees in the hospital set-up, and hence the patients will have to interact with all of them at a glance. Communication is vital in case of critical information, and hence teamwork should be maintained (Bryant Jerry 2014). Ineffective communication risks the lives of many patients due to obvious reasons which include missing information that is vital, poor interpretation of the context, making unclear orders, and even status of overlooked changes. Errors that may occur in this situation may cause damage to the health of the patient or death to some extent (Morgan, 2014). In most cases, doctors tend to be more prominent than nurses and in case the doctor scolds a nurse when corrected or consulted; the nurse always maintains silence in case an error is noted agai n (Blyund et al., 2012). Interdependent healthcare should be made to bring about success in medical practitioners line of duty, and hence nurses should not be silenced or even scolded because it creates more room for the creation of errors (Hughes, 2008). Neglecting the agreement made while becoming a health worker leads to complete deployment and one may spend a very long time in jail after being fired (Brown, 2013). In conclusion, health care providers should provide treatment to all people regard to their race, ethnicity, social class, gender or even age. Healthcare providers should ensure team work is maintained at all cost to understand the patient rights and needs. Emphasis should be put on areas related to social and health. They should train in providing a solution to many problems including counseling, lab technologist, and roles. During the study, students should employ most of teamwork principles and communication to enable them to solve clinically related problems as a team and give one another an equal chance to speak out what they know, while accepting corrections. References Britt, H., Miller, G. C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., O'Halloran, J. (2013). General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health (No. 33). Sydney University Press. Brown, T. (2013). Healing the hospital hierarchy. The New York Times, 16. Bryant, C., Jary, D. (2014). Giddens' theory of structuration: A critical appreciation. Routledge. Bylund, C. L., Peterson, E. B., Cameron, K. A. (2012). A practitioner's guide to interpersonal communication theory: An overview and exploration of selected theories. Patient education and counseling, 87(3), 261-267. Coburn, D. (2015). Vicente Navarro: Marxism, Medical Dominance, Healthcare and Health. In The Palgrave Handbook of Social Theory in Health, Illness and Medicine (pp. 405-423). Palgrave Macmillan UK. Cockerham, W. C. (2014). Medical sociology. John Wiley Sons, Ltd. Connell, R. (2012). Gender, health and theory: conceptualizing the issue, in local and world perspective. Social science medicine, 74(11), 1675-1683. Craib, I. (2015). Modern social theory. Routledge. Hughes, R. G. (2008). Chapter 33: Professional Communication and Team Collaboration. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Liu, W., Manias, E., Gerdtz, M. (2013). Medication communication during ward rounds on medical wards: Power relations and spatial practices. Health:, 17(2), 113-134. Lowe, G., Plummer, V., OBrien, A. P., Boyd, L. (2012). Time to clarifythe value of advanced practice nursing roles in health care. Journal of advanced nursing, 68(3), 677-685. Marchildon, G. P. (2013). Health systems in transition: Canada (Vol. 7, No. 3). University of Toronto Press. Marsland, D. (2014). Progress In Health Care: A Sociological Appreciation Of The Nhs Review And Its Potential Benefits. A Journal of the BSA MedSoc Group. McDonald, J., Jayasuriya, R., Harris, M. F. (2012). The influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitus. BMC health services research, 12(1), 63. Morgan, D. H. J. (2014). Social Theory and the Family (RLE Social Theory). Routledge. Scambler, G. (Ed.). (2013). Habermas, critical theory and health. Routledge. Shepherd, C. C., Li, J., Zubrick, S. R. (2012). Social gradients in the health of Indigenous Australians. American journal of public health, 102(1), 107-117. Snyder, M., Deaux, K. (2012). Personality and social psychology. In The Oxford handbook of personality and social psychology. Spehar, I., Frich, J. C., Kjekshus, L. E. (2014). Clinicians in management: a qualitative study of managers use of influence strategies in hospitals. BMC health services research, 14(1), 251. Thomson, S., Osborn, R., Squires, D., Jun, M. (2012). International profiles of health care systems 2012: Australia, Canada, Denmark, England, France, Germany, Iceland, Italy, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Wallensteen, P. (2015). Understanding conflict resolution. Sage Willis, E., Reynolds, L., Keleher, H. (Eds.). (2016). Understanding the Australian health care system. Elsevier Health Sciences. Wuest, J. (2012). Grounded theory: The method. Nursing research: A qualitative perspective, 5, 225-256.