HEALTH, ILLNESS, AND HEALING IN AN UNCERTAIN ERA - CHALLENGES FROM AND FOR MEDICAL SOCIOLOGY

The current situation in health care organizations, among providers an d for people, dramatically challenges the ''business as usual'' roles of medicine, government, insurance companies, the community, and the u niversity. Health care reform marks the first attempt in a century to consider a reconstruction of the social contract between society and m edicine. While sociology stands as one of the earliest social sciences to systematically study the health care arena and create a health-foc used subfield, there is a perception, nor without support, of a desert ion of identity from within, an encroachment by other areas from witho ut, and abandonment by the parent discipline. We argue that these situ ations in medical arenas and in research fields require serious rethin king. The key lies in understanding how these phenomena are related to each other and to larger social forces, and how they offer opportunit ies, rather than signal limitations, to medical sociologists. We turn to the theoretical tools of sociology to help unravel the complicated challenges that face both policymakers and researchers. After framing these issues in a sociology of knowledge perspective, we use the case of ''utilization theory'' to illustrate the connections between societ y and systems of care (as well as studies of them) and to create a fut ure agenda. We end by raising three basic questions: (1) Why is a soci ological perspective critical to the understanding of change and refor m in health care? (2) Why is medical sociology critical to the surviva l of the general sociological enterprise? and (3) Why is general socio logy critical to the research agenda in medical sociology?