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McDonaldization Effecting our Worlds Healthcare
In our society healthcare plays a very dominant role which is effected by McDonaldization. In Canada, citizens are provided with clinics to visit in hopes to resolve their medical conditions. We as citizen are blessed to have free healthcare available, but the effect McDonaldization has had on it is typically overlooked and ignored. Society alone plays a role in individuals health and the healthcare system, but many social concepts such as McDonaldization, do as well which can be controlled or stopped. McDonaldization is a reconceptualization of rationalization and scientific management (Ritzer, 2004). It has the ability to completely dehumanize the social institutions in America and the rest of the world (Ritzer, 2004). Without measure to counter, McDonaldization will threaten medicine’s most cherished and defining value including care for the individual and meaningful patient-physician relationships. Looking at healthcare through the lens of McDonaldization interests me because growing up in Canada I have never realized how much society has caused key aspects of healthcare to be taken away. By understanding McDonaldization and the social issues behind healthcare I am able to recognize the changes our healthcare system has undergone from when I was born until present as well as over multiple generations. I find McDonaldization to be fascinating as it effects so many large aspects in our lives and will continue to work its way into more. Applying it to healthcare opens my eyes to how society’s mindset causes changes that not only effects one cohort of people, but an entire nation. McDonaldization has led healthcare to become centred around efficiency, calculability, predictability and nonhuman machines taking away from the personal aspects of clinic visits.
McDonaldization is a term invented by George Ritzer to describe a sociological phenomenon that is happening in society. By definition is it “the process by which the principles of the fast-food restaurant are coming to dominate more and more sectors of American society as well as of the rest of the world” (Ritzer, 2004, p. 1). McDonald’s and other fast-food restaurants offer an alternative to labour-intensive, home-cooked meals that have been attractive to busy families since the 1950’s. In the 1950’s Ray Kroc began the franchise of McDonald’s restaurants (Ritzer, 2004). As the franchise grew it began to be rationalized in order to discover the most efficient method for competing each task (Ritzer, 2004). The four main dimensions of McDonaldization are efficiency, calculability, predictability, and control. Firstly, efficiency refers to the optimum method of completing a task (Ritzer, 2004). It seeks to reach the best mode of production, where individuality are not allowed (Ritzer, 2004). Secondly, calculability is the assessment of outcomes based on quantifiable rather than subjective criteria (Ritzer, 2004). It focuses on quantity over quality. Predictability focuses on the production process being organized in order to guarantee uniformity of product and standardized outcomes (Ritzer, 2004). Lastly, control is achieved through nonhuman technology. The concept of nonhuman machines includes the substitution of human labour with non-human labour, through automation or the deskilling of the work force (Ritzer, 2004). McDonaldization allowed for convenience and affordability, which are qualities that are becoming increasingly important in all aspects of our modern society.
While viewing society, it is recognizable that social class is linked to health and illness, illustrating the many ways in which healthcare is an urgent problem in society. Health care refers to the provision of medical services to prevent, diagnose, and treat health problems. Health and illness is not only a medical problem, but also a social problem effecting both the healthcare providers and the clients. Different from physicians, sociologists do not try to decipher why anyone becomes ill, but rather examines rates of illness in hopes to explain why people from certain social background are more likely than others to become sick. Sociologist have proven that our social backgrounds including our social class, race, ethnicity, and gender make a critical difference. When an individual gets sick there is always a medical cause of the person’s illness and a doctor does their best to try and cure it. Sickness is influenced by one’s genes, but social background also plays an important role. From a conflict theory approach, social inequality characterizes the quality of health and the quality of health care. In Canada, we are provided with easy access to medical help, but over time rationalization has begun to influence the care we receive. From a functionalist approach, it would be seen that effective medical care is essential for the smooth functioning of society. The doctor provides instructions and the patient needs to follow them. Once again rationalization has impacted and changed the doctor-patient relationship. Healthcare is a vital social issue, which is becoming more of a problem as McDonaldization begins to take over.
Impact of McDonaldization on Healthcare
Whether conscious or not McDonaldization has effected and changed the healthcare system in a variety of ways. In the past, health care was simplistic in nature. Doctors knew all of their patients and their families on a personal level. Follow-up appointments were normal as doctors were concerned about patients progress for their own peace of mind. This is no longer the case. McDonaldization has found its way into healthcare taking away from beneficial aspect of healthcare. Firstly, the factor of efficiency has led to minute clinics, patients completing questionnaires, broader use of medical assistants, robotic surgery, and brief visits with physicians. In today’s societies clinics often employ less expensive and skilled physicians in order to reduce the time physicians spend with patients. From an individual’s first interaction with the receptionist patients are typically given a questionnaire in hopes to decrease time needed with the doctor. As McDonaldization makes its way deeper into healthcare it is recognizable that medical assistants have begun to play a greater role in client’s visits. Rather than the doctor taking individuals blood pressure or other medical testing’s it has become the medical assistant’s role, once again in hopes to help shorten the time spend with the doctor. The second factor of McDonaldization is calculability. In light of healthcare, patients are not immune to calculability as the care they receive is increasingly a function of cost and financial return to the system. Rather than focusing on the quality of the service they are receiving, patients are overcome and focused on how much the service is going to cost. Quality measure, such as length of stay, typically confuses quantity with quality.
Thirdly, predictability has effected healthcare in many ways. A simple visit to the doctor has now become formulaic. When entering a clinic, the receptionist will begin by filling out the necessary paperwork and informs the doctor of the patient’s arrival. The nurse will typically then take your temperature, pulse rate, and blood pressure and notes his/her findings with little human interaction. Once complete patients wait until the doctor comes and asks questions. The patient will inform the doctor of symptoms they are experiencing in order for the doctor to diagnosis the condition and provide a prescription or advise that is needed. Each step a patient goes through is a part of a precise guideline. Clinical guidelines are valuable, but lead to greater pressure on doctors to treat all patients the same. Predictability has led to an overuse of checklists in order to uniform everyone’s visit. Uniform length can result in equal care, but it does not necessarily address individual needs. Lastly, nonhuman machines are beginning to become more involved in healthcare. It is influencing small aspects of it such that pharmacies now can have prescriptions delivers to customers home, much like a machine would. Technology also influences large aspects of the healthcare system as medical records became electronic. Electronic medical records control interactions between the doctor and patients by specifying what questions must be asked and what tasks must be completed. The judgment of a computer substitutes that of a doctor, leading the doctor to spend far more time with computers than with patients. Technology substitution takes away from customer satisfaction and may be inefficient.
McDonaldization has and is still effecting societies healthcare system causing it to become increasingly efficient, calculable, predictable and controlled by nonhuman machines. McDonaldization has taken away from the personal, intentional aspect of doctor visits and has been replaces by rationalization and a desire to speed up appointments. Clinics are becoming more and more focused with how quickly they can get patients through the door rather than ensuring that they fully diagnose and treat the medical condition at hand. Doctors no longer take the time to personally get to know and interact with their patients. Aspects of society has caused doctors to follow a specific script which is provided online to ensure that all patients are receiving equal attention rather than the amount of attention and time their medical condition may require. McDonaldization is continually making its way into more aspects of healthcare. We as citizens must voice our opinions to fight for the healthcare we deserve.
- Ritzer, George. (2004). An introduction to McDonaldization. McDonaldization of Society,revised new century edition, 1-23.
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