Social Issues In Diagnosis

Understanding the social process of diagnosis is critical to improving doctor-patient relationships and health outcomes. Diagnosis, the classification tool of medicine, serves an important social role. It confers social status on those who diagnose, and it impacts the social status of those diagnosed. Studying diagnosis from a sociological perspective offers clinicians and students a rich and sometimes provocative view of medicine and the cultures in which it is practiced. Social Issues in Diagnosis describes how diagnostic labels and the process of diagnosis are anchored in groups and structures as much as they are in the interactions between patient and doctor. The sociological perspective is informative, detailed, and different from what medical, nursing, social work, and psychology students—and other professionals who diagnose or work with diagnoses—learn in a pathophysiology or clinical assessment course. It is precisely this difference that should be integral to student and clinician education, enriching the professional experience with improved doctor-patient relationships and potentially better health outcomes. Chapters are written by both researchers and educators and reviewed by medical advisors. Just as medicine divides disease into diagnostic categories, so have the editors classified the social aspects of diagnosis into discrete areas of reflection, including • Classification of illness • Process of diagnosis • Phenomenon of uncertainty • Diagnostic labels • Discrimination • Challenges to medical authority • Medicalization • Technological influences • Self-diagnosis Additional chapters by clinicians, including New York Times columnist Lisa Sanders, M.D., provide a view from the front line of diagnosis to round out the discussion. Sociology and pre-med students, especially those prepping for the new MCAT section on social and behavioral sciences, will appreciate the discussion questions, glossary of key terms, and CLASSIFY mnemonic.

Finalist, Foundation for the Sociology of Health and Illness Book Prize, British Sociological Association Over a decade after medical sociologist Phil Brown called for a sociology of diagnosis, Putting a Name to It provides the first book-length, comprehensive framework for this emerging subdiscipline of medical sociology. Diagnosis is central to medicine. It creates social order, explains illness, identifies treatments, and predicts outcomes. Using concepts of medical sociology, Annemarie Goldstein Jutel sheds light on current knowledge about the components of diagnosis to outline how a sociology of diagnosis would function. She situates it within the broader discipline, lays out the directions it should explore, and discusses how the classification of illness and framing of diagnosis relate to social status and order. Jutel explains why this matters not just to doctor-patient relationships but also to the entire medical system. As a result, she argues, the sociological realm of diagnosis encompasses not only the ongoing controversy surrounding revisions to the Diagnostic and Statistical Manual of Mental Disorders in psychiatry but also hot-button issues such as genetic screening and pharmaceutical industry disease mongering. Both a challenge and a call to arms, Putting a Name to It is a lucid, persuasive argument for formalizing, professionalizing, and advancing longstanding practice. Jutel’s innovative, open approach and engaging arguments will find support among medical sociologists and practitioners and across much of the medical system.

Understanding the social process of diagnosis is critical to improving doctor-patient relationships and health outcomes. Diagnosis, the classification tool of medicine, serves an important social role. It confers social status on those who diagnose, and it impacts the social status of those diagnosed. Studying diagnosis from a sociological perspective offers clinicians and students a rich and sometimes provocative view of medicine and the cultures in which it is practiced. Social Issues in Diagnosis describes how diagnostic labels and the process of diagnosis are anchored in groups and structures as much as they are in the interactions between patient and doctor. The sociological perspective is informative, detailed, and different from what medical, nursing, social work, and psychology students—and other professionals who diagnose or work with diagnoses—learn in a pathophysiology or clinical assessment course. It is precisely this difference that should be integral to student and clinician education, enriching the professional experience with improved doctor-patient relationships and potentially better health outcomes. Chapters are written by both researchers and educators and reviewed by medical advisors. Just as medicine divides disease into diagnostic categories, so have the editors classified the social aspects of diagnosis into discrete areas of reflection, including • Classification of illness • Process of diagnosis • Phenomenon of uncertainty • Diagnostic labels • Discrimination • Challenges to medical authority • Medicalization • Technological influences • Self-diagnosis Additional chapters by clinicians, including New York Times columnist Lisa Sanders, M.D., provide a view from the front line of diagnosis to round out the discussion. Sociology and pre-med students, especially those prepping for the new MCAT section on social and behavioral sciences, will appreciate the discussion questions, glossary of key terms, and CLASSIFY mnemonic.

Social anxiety disorder is persistent fear of (or anxiety about) one or more social situations that is out of proportion to the actual threat posed by the situation and can be severely detrimental to quality of life. Only a minority of people with social anxiety disorder receive help. Effective treatments do exist and this book aims to increase identification and assessment to encourage more people to access interventions. Covers adults, children and young people and compares the effects of pharmacological and psychological interventions. Commissioned by the National Institute for Health and Clinical Excellence (NICE). The CD-ROM contains all of the evidence on which the recommendations are based, presented as profile tables (that analyse quality of data) and forest plots (plus, info on using/interpreting forest plots). This material is not available in print anywhere else.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

The publication of the Cultural Formulation Outline in the DSM-IV represented a significant event in the history of standard diagnostic systems. It was the first systematic attempt at placing cultural and contextual factors as an integral component of the diagnostic process. The year was 1994 and its coming was ripe since the multicultural explosion due to migration, refugees, and globalization on the ethnic composition of the U.S. population made it compelling to strive for culturally attuned psychiatric care. Understanding the limitations of a dry symptomatological approach in helping clinicians grasp the intricacies of the experience, presentation, and course of mental illness, the NIMH Group on Culture and Diagnosis proposed to appraise, in close collaboration with the patient, the cultural framework of the patient's identity, illness experience, contextual factors, and clinician-patient relationship, and to narrate this along the lines of five major domains. By articulating the patient's experience and the standard symptomatological description of a case, the clinician may be better able to arrive at a more useful understanding of the case for clinical care purposes. Furthermore, attending to the context of the illness and the person of the patient may additionally enhance understanding of the case and enrich the database from which effective treatment can be planned. This reader is a rich collection of chapters relevant to the DSM-IV Cultural Formulation that covers the Cultural Formulation's historical and conceptual background, development, and characteristics. In addition, the reader discusses the prospects of the Cultural Formulation and provides clinical case illustrations of its utility in diagnosis and treatment of mental disorders. Book jacket.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.