“If I were to pick between a free trip to Bermuda or to do a lung transplant, I would probably do the lung transplant” (Dr. D, Chief of cardiothoracic, “Boston Med”). The first episode of the TV show, Boston Med demonstrates some examples of the functionalist theory and symbolic interactionism theory. Talcott Parsons, an American sociologist, defines the functionalist theoretical perspective and describes the sick role, ideal patient, and ideal doctor theories. The Symbolic interactionism theory describes the interaction among a doctor and a patient under various circumstances. In this essay, I will use concrete examples from Boston Med to discuss how being sick gives an exemption from normal responsibilities, there are important characteristics for being an ideal doctor and an ideal patient, and there are subcategories for the sick role theory that view sickness differently. In addition, I will try to show how changes in lifestyle may be needed to adapt to chronic disease, and how there are different kinds of relationships between a doctor and a patient.
Sick Role Theory
Functionalism is a theoretical perspective that views each part of society as a contributor to fill the needs to achieve stability of the society. For example, in the United States, the government provides education to children so they find a job and support the government by paying taxes. Talcott Parsons studied the doctor-patient relationship and developed the sick role theory, which outlines four expectations for every ill patient. First, “the exemption from the normal social role responsibilities to stop the spread of illness […] Second, the sick person cannot be expected to get well by an act of decision or will […] Third, the state of being ill is undesirable by the sick person […] Fourth, the obligation to seek technically competent help, namely, in the most usual case, that of a physician” (Macionis and Benokraitis, 337). For example, in the TV show, Boston Med, an officer is shot by a criminal and has to go through several surgical operations to survive. The officer cannot come back to his daily job of keeping the community safe because of the healing period. The officer is exempt from his normal social role responsibilities because of his undesirable illness from the injury for a few days. Clearly, being ill at the hospital after a surgical operation is an example of the sick role theory since the officer is not expected to get well by an act of decision.
Ideal Doctor and Ideal Patient Theories
In addition to the sick role theory, Parsons describes some characteristics of the ideal physician and ideal patients. The ideal doctor theory explains that physicians have some expectations from their patients. Parsons says, “the ‘ideology’ of profession lays great emphasis on the obligation of the physicians to put the welfare of the patient above his personal interest” and apply a high degree of knowledge to act for the good of the patient (Macionis and Benokraitis, 376-377). In other words, physicians are expected to be well educated in their fields in order to treat their patients. Also, physicians are expected to remain objective and emotionally detached to be able to focus on their performance. On the other hand, Parsons, in the ideal patient theory, argues that patients are not held responsible for their current health, but are nonetheless expected to take steps to regain their health. Most of the time, patients should not be seen as responsible for their poor health. Therefore, physicians should always act professionally no matter how their patients act. In other words, the ideal doctor and ideal patient theories demonstrate that doctors are expected to be professional in their fields to treat their patients. Patients are exempt from their normal responsibilities and not seen responsible for their sickness.
Boston Med Demonstrates Ideal Doctor and Patient Theories
Boston Med provides an example of the ideal doctor and ideal patient theories and how being a physician or an ill patient is challenging. For example, the ER resident in the episode is referred to as “sweetheart” by an intoxicated patient while treating him. Even though the ER resident hates being called sweetheart, she has to control her angry feelings and focus on treating the patient. This is an example of the ideal doctor theory by being professional and understanding that the patient is uninhibited of what he’s saying. On the other hand, the episode also shows a patient who has a lung injury. Even though the patient was a college professor and had responsibilities, she has to stay at the hospital and wait for days to recover after the surgery. Since this patient has some health issues, she is exempt from her normal teaching responsibilities as a college professor until she returns to good health. The ER resident ignored her intoxicated patient’s language and is professional by focusing on treating the patient, and the college professor is excused from her job duties for a few days because of her surgery.
Benefits from Sick Role Theory
If being sick can give us an exemption from our normal job responsibilities, can we simply pretend to be sick whenever we do not want to work? The answer is no. The sick role theory cannot apply to people whose illnesses are hidden or to patients who reject adopting the sick role. However, the sick role theory has some subcategories. First, there is the “illegitimate role”, which is when patients are seen as responsible for their sickness. In Boston Med, there is a patient who needs a lung transplant because she has been smoking for over 20 years and her lungs have developed COPD, which it stands for chronic obstructive pulmonary disease. For some people, this patient is seen responsible for his lung disease since he chose to start smoking. Second, the “conditional sick role” is defined as conditions that are more likely to be cured by medications, such as physical pain or hypertension during surgery. For example, the ER resident gives her intoxicated patient a medication after suffering from an acute headache. After the patient is treated for his headache, the pain is gone and the patient is able to leave the hospital. Also, the ER resident uses saline for several surgeries to balance the blood pressure within the normal range. The third subcategory is the “unconditionally legitimate sick role”, which is defined as an incurable disease, such as cancer. Clearly, the three subcategories of sick roles show the various complications of health issues that physicians face every day at the hospital.
The Symbolic Interactionism theory
The Symbolic Interactionism theory for health focuses not on roles, but on the interaction between physicians and patients. First, this theory talks about patients’ reaction and adjustments to illness. For example, Michael Bury, an American physician, argues that the onset of chronic illness can be viewed as a “biographical disruption.” Bury said, “my contention is that illness, and especially chronic illness, is precisely that kind of experience where the structures of everyday life… are disrupted” (Bury, 169). In other words, chronic illnesses require adapting new lifestyles, which forms a new identity. For example, the patient who needs the lung transplant after contracting COPD from smoking, has to adapt her new lifestyle of living in the hospital until she has a lung transplant. This is difficult for this patient and her family since her family is able to see her only in the hospital: “My wife is a great woman and she deserves a second chance in life” (patient’s husband, Boston Med). This patient can barely talk and is always put on oxygen support. By the end of the episode, this patient and her husband hear about a possible lung donor from a car accident, which could change their lives again. COPD has changed this patient’s lifestyle because she can no longer walk outside the hospital and see her family whenever she wants.
Under the Symbolic Interactionism theory, there are four prototypes of patient-physician relationships, which are paternalistic, default, consumerism, and mutuality. In Boston Med, we see most evidently paternalistic relationship, which suggests that the doctor is the expert and patients are expected to be cooperative: “We believe in you Dr. D, you can perform this lung transplant successfully” (patient’s family, Boston Med). This patient’s family receives the news that their mother will be able to have a lung transplant, and they believe that Dr. D will perform this surgery successfully. In this episode, the paternalistic relationship is demonstrated since Dr. D, who graduated from Harvard Medical School, tells what the patient is exactly supposed to do and makes the decision of when the lung transplant can happen. While Dr. D is heading to the operating room to see the donor’s lungs, he says, “The lungs could be healthy and in a great shape, but there is a chance that the patient’s body could not accept it. I have to see the lungs’ condition” (Dr. D, Boston Med). Clearly, the relationship between Dr. D and his patient’s family is paternalistic since Dr. D is the “parent” who is making the judgmental call of when to perform the surgery and how the patient and his family are cooperative and believe in their doctor.
To achieve a stable society, each part of the society needs to perform its role. However, this cannot be achieved without cooperation. The sick role theory contributes to achieving a stable society by giving people the chance to recover from their illness and do their jobs to the best of their abilities. Physicians contribute to the society by treating sick patients with their best knowledge and skills. But how can we achieve stability in our society if not everyone can afford healthcare? Patients may not be cooperative and follow their doctor’s suggestions. Since some people cannot afford their medications, they may not heal and thus, they may not heal and thus, they cannot do their jobs properly. The US healthcare system is unique and complicated but imagine if the US had a uniform health system and universal healthcare coverage. I believe that improving our healthcare system can have a great impact on the stability of the society.