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Medicalization is the increasing social control of the everyday by medical experts. It is a key concept in the sociology of health and illness because it sees medicine as not merely a scientific endeavor, but a social one as well. Medicalization is a “process whereby more and more of everyday life has come under medical dominion, influence, and supervision” (Zola, 1983, p. 295); previously these areas of everyday life were viewed in religious or moral terms (Conrad & Schneider, 1980; Weeks, 2003). More specifically, medicalization is the process of “defining a problem in medical terms, using medical language to describe a problem, adopting a medical framework to understand a problem, or using a medical intervention to ‘treat’ it” (Conrad, 1992, p. 211). Sociologists have used this concept to describe the shift in the site of decision-making and knowledge about health from the lay public to the medical profession.

With an aim to investigate the recent state of the feminist clinics and their negotiation of medical authority in a time of increased technoscientific biomedicalization, and capitalistic health-care system, I conducted a study of two feminist health centers in the Northeast of the United States in 2001–2002. In this chapter, I discuss how the two centers (a nonprofit collective and a for-profit center with a more hierarchical structure) negotiated medical authority in organizational terms as impacted by the larger context of medicine and its interaction with the state, capitalist health-care system, and antiabortion forces. The chapter concludes with a discussion of demedicalization as a multilevel process and implications for feminist care (service delivery) and U.S. Women's Health Movement.

Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.

We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.

The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.

While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.

Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.

Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.

This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.

This study illustrates that differences across health-related websites, as well as different Internet usage patterns, have significant implications for how individuals view and interact with their health care providers.

We rely on a qualitative study of three health-related websites and an ordinary least squares regression analysis of survey data to explore how websites with different organizational motives frame health-related issues and how variations in Internet usage patterns affect patients’ perceptions of the patient-doctor interaction.

Results reveal differences across three health-related websites and show that both the number and the type of websites patients visit affect their perceptions of physicians’ responses. Specifically, visiting multiple websites decreased perceptions of how well doctors listened to or answered patients’ questions, whereas using nonprofit or government health-related websites increased evaluations of how well doctors listened to and answered questions.

This study suggests that practitioners and scholars should look more closely at how patients use the Internet to understand how it affects doctor-patient interactions. Future research could expand the analysis of website framing or use methods such as in-depth interviewing to more fully understand on-the-ground processes and mechanisms.

This study highlights the importance of fleshing out nuances about what it means to be an Internet-informed patient given that varying patterns of Internet use may affect how patients perceive their physicians.

Using data from the General Social Survey (2002), structural equation modeling is employed to examine the intersections and relationships between various socio-demographic and contextual variables, patient trust, and patient preference for behaviors that indicate a desire to be an active health care participant. In so doing, a gap in the literature is addressed by uniting previous research on patient trust with research on patient participation. Findings reveal that patient trust in doctors and various socio-demographic and contextual variables are associated with people wanting to participate in the health care process by learning about medical issues on their own and by contributing to medical decisions. Results also shed new light on past research, which finds a relationship between various socio-demographic variables and patient trust. Specifically, they highlight the importance of distinguishing between patient trust in doctors and patient trust in the broader health care institution and the economic pressures it exerts on doctors. A discussion of what these findings might mean for our understanding of the doctor-patient relationship and the delivery of health care concludes the chapter.

Rural Australian patients continue to receive inadequate medical attention. One potential solution to this is to train Indigenous Australians to become medical doctors and return to their community to serve their people. The study aims to examine whether Indigenous medical students have a stronger intention to practice in underserved communities.

A sample of Indigenous (N = 17) and non-Indigenous students (N = 188) from a medical program in Sydney was surveyed about their medical self-concept and motivation. Confirmatory factor analysis (CFA) was conducted, group differences were tested, and correlation patterns were examined.

CFA found seven distinct factors – three medical self-concepts (affective, cognitive, and cultural competence), one motivation factor, and three work-related variables – intention to serve underserved communities (intention), understanding of Indigenous health (understanding), and work-related anxiety (anxiety). Indigenous medical students were higher in cultural competence, intention, and understanding. Both the affective and cognitive components of medical self-concept were more highly correlated with intention and understanding for Indigenous students than for non-Indigenous students.

It is important to examine medical students’ self-concepts as well as their cultural characteristics and strengths that seed success in promoting service to underserved Indigenous communities.

The findings show that Indigenous medical students tended to understand Indigenous health issues better and to be more willing to serve underserved Indigenous communities. By enhancing both the affective and cognitive components of medical self-concepts, the “home-grown” medical education program is more likely to produce medical doctors to serve underserved communities with a good understanding of Indigenous health.

Purpose: To demonstrate how an online coaching intervention can support well-being management (mental health and mood) of medical students, by increasing psychological awareness, emotional management, and healthy/positive action repertoires.

Design/methodology/approach: A two-group randomized control trial design using a waitlist as a control was used with a sample of 176 medical students. Half were randomly assigned the 5P© coaching intervention and the remaining half assigned to the waitlist group, scheduled to receive the intervention after the initial treatment group completed the intervention. Participant baseline data on stress, anxiety, depression, positive and negative affect, and psychological capital were obtained prior to commencing the study, after completion of the first treatment group, and again postintervention of the waitlisted group, and then at the end of the year.

Findings: Coaching the students to reflect on their emotions and make solution-focused choices to manage known stresses of medical education was shown to decrease medical student stress, anxiety, and depression, thereby increasing the mental health profiles of medical students.

Research limitations/implications: The findings suggest that an online coaching tool that increases psychological awareness and positive action can have a positive effect on mental health and mood of medical students.

Practical implications: The framework developed and tested in this study is a useful tool for medical schools to assist medical students in managing their well-being, thereby decreasing the incidence and prevalence of mental illness in medical students. The implications of this research are significant in that positively affecting the psychological well-being of medical students could have a significant effect not only on each medical student but also on every patient that they treat, and society as a whole. Better mental health in medical students has the potential to decrease dropout rates, increase empathy and professionalism, and allow for better patient care.

Originality/value: This study contributes to the literature on online coaching for improved psychological well-being and emotional regulation, mental health, and medical students. It is one of the first studies using a coaching protocol to make a positive change to the known stress, anxiety, and depression experienced by medical students worldwide.

Purpose – This chapter examines medical consumerism and the changing relations between patients as consumers and the medical system across two women's health contexts, breast cancer and infertility.

Methodology/approach – The analysis draws on two qualitative studies: The first explores the experiences of 60 breast cancer survivors through in-depth interviews and participant observation (Sulik, 2005), and the second uses in-depth interviews to analyze 18 women's experiences with infertility (Eich-Krohm, 2000).

Findings – The medical consumer is an individualized role that shifts attention away from the quality problem in health care and toward the quality of the person as a medical consumer who is characterized to be optimistic, proactive, rational, responsible, and informed.

Research limitations/implications – As medicine has become a form of mass consumption, the category of medical consumer has elevated the individual in medical decision-making. The shift from patient to medical consumer is an ongoing process that is grounded in a tension between medical control and individual agency, and is exacerbated by the intensity and incomprehensibility of modern medicine.

Practical implications – The proliferation of medical information and personal illness narratives through the Internet, advice books, and self-help groups have advanced lay knowledge about preventive medicine and medical treatment while simultaneously introducing new fears and anxiety about the multitude of options and outcomes.

Originality/value of chapter – This study contributes to our knowledge on medical consumerism and its impact on illness experience and the synthesis of lay and professional knowledge.

In this introductory chapter, I discuss the rationale for this edited collection and the contribution it can make to advancing knowledge of gender inequalities and promoting social justice in the medical profession and medical education. I provide a short overview of and critique of popular debates in the medical community in the United Kingdom and I also discuss briefly research about women’s careers in the United Kingdom and globally. The introductory chapter provides a description of each chapter and its contribution to scholarship about gender, careers and inequalities in Medicine/Medical Education.