Reforming Medical Education: Towards a Broadening of Attitudes

  • Margaret Lock
  • Joseph Lella


About ten years ago, in an attempt to alleviate the financial insolvency associated with writing a Ph.D. thesis, one of us became part of a team of four people employed as raters of mother/infant behaviour. The study, done in California, made use of home movies taken during the first six months in an infant’s life. It was known that some of the babies had become diagnosed as schizophrenic in later childhood, and our job was to rank episodes of mother/infant interaction, eye contact, holding and feeding techniques, and so on, on a five point scale. Mother and infant were evaluated separately. It was hypothesized that the behaviour of some mothers and some infants (not necessarily in the same family), would allow one to predict by the age of six months which children were at serious risk for becoming schizophrenics in the future. We could then check our experimental findings against what had actually become reality.


Medical Education Estrogen Replacement Therapy Health Belief Model Biopsychosocial Model Biopsychosocial Approach 


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  1. Armstrong, D. (1984). The patient’s view. Social Science and Medicine, 18, 737–744.PubMedCrossRefGoogle Scholar
  2. Arney, W. R. (1982). Power and the profession of obstetrics. Chicago: University of Chicago Press.Google Scholar
  3. Bates, D. (1973). Humanism in undergraduate medical education. In J. P. McGovern (Ed.), Humanism in medicine. Springfield, IL: Charles C. Thomas.Google Scholar
  4. Becker, M. (1974). (Ed.). The health belief model and personal health behavior. Health Education Monograph, Vol. 2, No. 2.Google Scholar
  5. Berkman, L. F. (1981). Physical health and the social environment: A social epidemiological perspective. In L. Eisenberg & A. Kleinman (Eds.), The relevance of social science for medicine. (pp. 51–75). Boston: Reidel.CrossRefGoogle Scholar
  6. Bourne, G. (1931). An introduction to medical history and case-taking. Edinburgh: Edinburgh Livingstone.Google Scholar
  7. Brown, G. W. & T. Harris. (1978). Social origins of depression: A study of psychiatric disorder in women. London: Tavistock.Google Scholar
  8. Bruyn, S. (1966). The human perspective in sociology. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  9. Bylebyl, J. (1982). Introduction. In J. Bylebyl (Ed.), Teaching the history of medicine at a medical center (pp. 1–12). Baltimore: Johns Hopkins University Press.Google Scholar
  10. Coope, J., Thomson, J. M., & Potter, L. (1975). Effects of “natural aestrogen” replacement therapy on menopausal symptoms and blood clotting. British Medical Journal.Google Scholar
  11. Engel, G. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–196.PubMedCrossRefGoogle Scholar
  12. Engel, G. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535–544.PubMedGoogle Scholar
  13. Evans-Pritchard, E. E. (1937). Witchcraft, oracles and magic among the Azande. Oxford: Clarendon Press.Google Scholar
  14. Foucault, M. (1963). The birth of the clinic: An archeology of medical perception. London: Tavistock.Google Scholar
  15. Foucault, M. (1965). Madness and civilization. New York: Random House.Google Scholar
  16. Freidson, E. (1970). Profession of medicine: A study of the sociology of applied knowledge. New York: Dodd, Mead.Google Scholar
  17. Freud, S. (1910). The future prospects of psychotherapy. In P. Rieff, (Ed.), Freud: Therapy and technique, Chapter V. (pp. 77–88). New York: Collier Books, 1963.Google Scholar
  18. Geertz, C. (1973). The interpretation of cultures. New York: Basic Books.Google Scholar
  19. Gregory, M. S. (1984). Science and humanities: Toward a new world view. In D. S. Brock & A. Harward (Eds.), The culture of biomedicine. (Studies in Science and Culture, Vol. 1). (pp. 11–33). Newark: University of Delaware Press.Google Scholar
  20. Good, B. J. & Good, M. J. (1980). The meaning of symptoms: A cultural hermeneutic model for clinical practice. In L. Eisenberg & A. Kleinman (Eds.), The relevance of social science for medicine. Boston: Reidel.Google Scholar
  21. Hahn, R. A. & Gaines A. D. (Eds.). (1985). Physicians of Western medicine: Anthropological approaches to theory and practice. Boston:Reidel.Google Scholar
  22. Haynes, R. B., Taylor, D. W. & Sackett, D. L. (Eds.). (1979). Compliance in health care. Baltimore: Johns Hopkins University Press.Google Scholar
  23. Helman, C. (1985). Communication and primary care: The role of patient and practitioner explanatory models. Social Science and Medicine, 20, 923–931.PubMedCrossRefGoogle Scholar
  24. Illich, I. (1975). Medical nemesis: The expropriation of health. Toronto: McLelland and Stewart.Google Scholar
  25. Kaufert, P. (1984). Women and their health in the middle years: A Manitoba project. Social Science and Medicine, 18, 279–281.PubMedCrossRefGoogle Scholar
  26. Kennedy, D. A., Pattishall, E. G., & Baldwin, D. C. (1983). Medical education and the behavioral sciences. Baltimore: Association for the Behavioral Sciences and Medical Education.Google Scholar
  27. Kleinman, A. (1980). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine and psychiarty. Berkeley: University of California Press.Google Scholar
  28. Kleinman, A., Eisenberg, L., & Good, B. J. (1978). Culture, illness and care: Clinical lessons from anthropological and crosscultural research. Annals of Internal Medicine, 88, 251–258.PubMedGoogle Scholar
  29. Leila, J. W., Gill, D. G., & McGlynn, R. (1985). Basic curriculum content for the behavioral sciences in pre-clinical medical education. McLean, VA: Association for the Behavioral Sciences and Medical Education.Google Scholar
  30. Lock, M. (1980). East Asian medicine in urban Japan: Varieties of medical experience. Berkeley: University of California Press.Google Scholar
  31. Lock, M. (1985). Models and practice in medicine: Menopause as syndrome or life transition? In R. A. Hahn & A. D. Gaines (Eds.), Physicians of Western medicine: Anthropological approaches to theory and practice. Boston: Reidel.Google Scholar
  32. Malcolm, J. (1981). Psychoanalysis: The impossible profession. New York: Knopf.Google Scholar
  33. Marmot, M. G. & Syme, L. (1976). Acculturation and coronary heart disease in Japanese Americans. American Journal of Epidemiology, 104, 225–247.PubMedGoogle Scholar
  34. McKeown, T. (1979). The role of medicine: Dream, mirage, or nemesis. Oxford: Blackwell.Google Scholar
  35. McKinlay, S. & McKinlay, J. B. (1986). Health status and health care utilization by menopausal women. In L. Mastroianni & C. A. Paulsen (Eds.), Aging, reproduction and the climacteric. New York: Plenum Press.Google Scholar
  36. Novak, M. (1972). The liberation of imagination. Instituting human values in medicine: Proceedings of the second session. Philadelphia: Society for Health and Human Values.Google Scholar
  37. Osier, W. (1932). Medicine in the nineteenth century. Acquanimitas: With other addresses to medical students, nurses, and practitioners of medicine (3rd ed.). Philadelphia: Blakiston.Google Scholar
  38. Rogers, C. (1951). The training of counsellors and therapists. In Client-centered therapy: Its current practice applications and theory. Chapter 10. (pp. 429–478). Boston: Houghton-Mifflin.Google Scholar
  39. Ruffini, J. L. (Ed.) (1983). Advances in medical social science. New York: Gordon and Breach Science.Google Scholar
  40. Simons, R. C. (Ed.). (1985). Understanding human behavior. Health and Illness (3rd ed.). Baltimore: Williams and Wilkins.Google Scholar
  41. Starr, P. (1982). The social transformation of American medicine. New York: Basic Books.Google Scholar
  42. Stern, N. S. (1933). Clinical diagnosis: Physical and differential. New York: Macmillan.Google Scholar
  43. Taylor, K. (1985). Decision difficult: Physician behavior in the diagnosis and treatment of breast cancer. Unpublished doctoral dissertation. McGill University, Montreal, Department of Sociology.Google Scholar
  44. Thomas, Lewis, (1983). The youngest science: Notes of a medicine watcher . New York: Viking Press.Google Scholar
  45. Wright, P., & Treacher, A. (Eds.). (1982). The problem of medical knowledge: Examining the social construction of medicine. Edinburgh: Edingurgh University Press.Google Scholar
  46. Zola, I. K. (1972). Medicine as an institute of social control. Sociological Review, 20, 487–504.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1986

Authors and Affiliations

  • Margaret Lock
    • 1
  • Joseph Lella
    • 1
  1. 1.Department of Humanities and Social Studies in MedicineMcGill UniversityUSA

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