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Sick-Role Legitimization

  • Fredric D. Wolinsky

Abstract

The purpose of this chapter is to consider in detail the issue of sick-role legitimization. There are three major sections to the chapter. The first provides a brief review of the sick role in light of American values and social structure, including a description of the traditional Parsonian scheme and the changes in it that have been necessitated by modifications in the health care delivery system. This section also considers the emergence of sick-role legitimization as a crucial contemporary issue in health behavior, focusing on its use as a coping response, as an avoidance mechanism, and as a justification for failure. The second section focuses on the prevalence of sick-role legitimization, including the taking of sick leave, and the receipt of medications and other visible badges of courage. In the final section we consider the major implications of sick-role legitimization: the increasing demand for it in the face of the coming physician surplus, and its effect on the stability of structural role interdependencies in highly differentiated societies.

Keywords

Sick Leave Health Care Delivery System National Ambulatory Medical Care Survey Role Obligation Sick Individual 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Hospital Association. (1986). Hospital statistics (1985 ed.). Chicago: American Hospital Association.Google Scholar
  2. Anderson, O. W. (1985). Health services in the United States: A growth industry since 1875. Ann Arbor: Health Administration Press.Google Scholar
  3. Blau, P. M., & Duncan, O. D. (1967). The American occupational structure. Chicago: University of Chicago Press.Google Scholar
  4. Coe, R. M., Wolinsky, F. D., Miller, D. K., & Prendergast, J. M. (1984). Complementary and compensatory functions in social network relationships among the elderly. The Gerontologist, 24, 396–400.PubMedCrossRefGoogle Scholar
  5. Cole, S., & Lejeune, R. (1972). Illness and the legitimation of failure. American Sociological Review, 37, 347–356.PubMedCrossRefGoogle Scholar
  6. Conrad, P. (1975). The discovery of hyperkinesis: Notes on the medicalization of deviant behavior. Social Problems, 23, 12–21.PubMedCrossRefGoogle Scholar
  7. Conrad, P., & Scheider, J. W. (1980). Deviance and medicalization. St. Louis: Mosby.Google Scholar
  8. Department of Health, Education, and Welfare. (1975). Current estimates from the Health Interview Survey, United States, 1973 (DHEW Publication No. 75-1522). Washington, DC:6U.S. Government Printing Office.Google Scholar
  9. Department of Health and Human Services. (1982). Patients’ reasons for visiting physicians: National Ambulatory Medical Care Survey, United States, 1977–1978 (DHHS Publication No. 82-1717). Washington, DC: U.S. Government Printing Office.Google Scholar
  10. Department of Health and Human Services. (1983). Patterns of ambulatory care in general and family practice: The National Ambulatory Medical Care Survey, United States, January 1980–December 1981 (DHHS Publication No. 83-1734). Washington, DC: U.S. Government Printing Office.Google Scholar
  11. Department of Health and Human Services. (1986a). Current estimates from the National Health Interview Survey, United States, 1983 (DHHS Publication No. 86-1582). Washington, DC: U.S. Government Printing Office.Google Scholar
  12. Department of Health and Human Services. (1986b). Use of antimicrobial drugs in office-based practice, United States, 1980–81 (DHHS Publication No. 86-1746). Washington, DC: U.S. Government Printing Office.Google Scholar
  13. Department of Health and Human Services. (1987). Health, United States, 1986 (DHHS Publication No. 87-1232). Washington, DC: U.S. Government Printing Office.Google Scholar
  14. Durkheim, E. (1897; translated 1951). Suicide: A study in sociology. New York: Free Press.Google Scholar
  15. Durkheim, E. (1903; translated 1961). Moral education: A study in the theory and application of the sociology of education. New York: Free Press.Google Scholar
  16. Fox, R. C. (1979). Essays in medical sociology. New York: Wiley.Google Scholar
  17. Fox, R. C. (1985). Reflections and opportunities in the sociology of medicine. Journal of Health and Social Behavior, 26, 6–14.PubMedCrossRefGoogle Scholar
  18. Freidson, E. (1970). The profession of medicine: A study in the sociology of applied knowledge. New York: Harper & Row.Google Scholar
  19. Graduate Medical Education National Advisory Committee. (1981). Summary report of the Graduate Medical Education National Advisory Committee (DHHS Publication No. 81-651). Washington, DC: U.S. Government Printing Office.Google Scholar
  20. Haug, M., & Lavin, B. (1981). Practitioner or patient: Who’s in charge? Journal of Health and Social Behavior, 22, 219–229.CrossRefGoogle Scholar
  21. Haug, M., & Lavin, B. (1983). Consumerism in medicine: Challenging physician authority. Beverly Hills: Sage.Google Scholar
  22. Hayes-Bautista, D. (1976a). Termination of the patient-practitioner relationship: Divorce, patient style. Journal of Health and Social Behavior, 17, 12–22.PubMedCrossRefGoogle Scholar
  23. Hayes-Bautista, D. (1976b). Modifying the treatment: Patient compliance, patient control, and medical care. Social Science and Medicine, 10, 233–238.PubMedCrossRefGoogle Scholar
  24. Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213–218.PubMedCrossRefGoogle Scholar
  25. Honig-Parnass, T. (1982). The effects of latent social needs on physician utilization by immigrants: A replication study. Social Science and Medicine, 16, 505–514.PubMedCrossRefGoogle Scholar
  26. Illich, I. (1976). Medical nemesis. New York: Pantheon.Google Scholar
  27. Levine, S., & Kozloff, M. (1978). The sick role: Assessment and overview. Annual Review of Sociology, 4, 317–343.CrossRefGoogle Scholar
  28. Light, D. (1986). Organizational consequences of a physician surplus: An overview. Paper presented at the annual meeting of the American Sociological Association.Google Scholar
  29. McKinlay, J. (1975). Who is really ignorant: Patient or practitioner? Journal of Health and Social Behavior, 16, 136–145.CrossRefGoogle Scholar
  30. McKinlay, J. (1986). Proletarianization and the social transformation of doctoring. Paper presented at the annual meeting of the American Sociological Association.Google Scholar
  31. Mechanic, D. (1978). Medical sociology: A comprehensive text (2nd ed.). New York: Free Press.Google Scholar
  32. Mechanic, D. (1979). Development of psychological distress among young adults. Archives of General Psychiatry, 36, 1233–1239.PubMedCrossRefGoogle Scholar
  33. Mechanic, D. (1980). The experience and reporting of common physical complaints. Journal of Health and Social Behavior, 21, 146–155.PubMedCrossRefGoogle Scholar
  34. Mechanic, D. (1983). The experience and expression of distress: The study of illness behavior and medical utilization. In D. Mechanic (Ed.), Handbook of health, health care, and the health professions. New York: Free Press.Google Scholar
  35. Merton, R. K. (1957). Social theory and social structure. New York: Free Press.Google Scholar
  36. Myers, G. (1985). Aging and world-wide population change. In R. Binstock & E. Shanas (Eds.), Handbook of aging and the social sciences (2nd ed.). Princeton, NJ: Van Nostrand-Reinhold.Google Scholar
  37. Parsons, T. (1951). The social system. New York: Free Press.Google Scholar
  38. Parsons, T. (1958). Definitions of health and illness in light of American values and social structure. In E. G. Jaco (Ed.), Patients, physicians, and illness. New York: Free Press.Google Scholar
  39. Parsons, T. (1975). The sick role and the role of the physician reconsidered. Milbank Memorial Fund Quarterly, 53, 257–278.CrossRefGoogle Scholar
  40. Parsons, T., & Fox, R. C. (1952). Illness, therapy, and the modern urban American family. Journal of Social Issues, 8, 31–44.CrossRefGoogle Scholar
  41. Rice, D. P., & Feldman, J. (1983). Living longer in the United States: Changes and health needs of the elderly. Milbank Memorial Fund Quarterly, 61, 362–396.CrossRefGoogle Scholar
  42. Shuval, J. T. (1970). The social functions of medical practice. San Francisco: Jossey-Bass.Google Scholar
  43. Starr, P. (1982). The social transformation of American medicine: The rise of a sovereign profession and the making of a vast industry. New York: Basic Books.Google Scholar
  44. Suchman, E. (1965a). Social patterns of illness and medical care. Journal of Health and Human Behavior, 6, 2–16.PubMedCrossRefGoogle Scholar
  45. Suchman, E. (1965b). Stages of illness and medical care. Journal of Health and Human Behavior, 6, 114–128.PubMedCrossRefGoogle Scholar
  46. Tessler, R., & Mechanic, D. (1978). Psychological distress and perceived health status. Journal of Health and Social Behavior, 19, 254–262.PubMedCrossRefGoogle Scholar
  47. Tessler, R., Mechanic, D., & Dimond, M. (1976). The effect of psychological distress on physician utilization: A prospective study. Journal of Health and Social Behavior, 17, 353–364.PubMedCrossRefGoogle Scholar
  48. Wan, T. T. H. (1985). Gerontological health and role loss in the later years. Lexington: Lexington Books.Google Scholar
  49. West, C. (1984). Routine complications: Troubles with talk between doctors and patients. Bloomington: Indiana University Press.Google Scholar
  50. Wolinsky, F. D. (1988). The sociology of health: Principles, practitioners, and issues (2nd ed.). Belmont: Wadsworth.Google Scholar
  51. Wolinsky, F. D., & Wolinsky, S. R. (1981). Expecting sick-role legitimation and getting it. Journal of Health and Social Behavior, 23, 229–242.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Fredric D. Wolinsky
    • 1
  1. 1.Department of SociologyTexas A & M UniversityCollege StationUSA

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