Simmel's dynamic social medicine: new questions for studying medical institutions?

Over the last half century, changes in the structure of medicine have shifted the relationship between the profession of medicine and social institutions. In this paper, I uncover ideas for retheorizing this relationship by analyzing a review by Georg Simmel that has been previously overlooked. In an analytical overview and critical appraisal of Simmel's text, I argue that he considered preventative medical knowledge more influential when this knowledge is located outside the physician-patient relationship. Simmel suggests we need to identify how such knowledge is injected into medical and non-medical settings by the mixtures of professional-, market-, and state-based institutions governing medicine, and pay attention to how these institutions shift. His goals show continuity with a social medicine movement in Germany previously thought to be stalled, and are unique too in their focus on targeting institutions over individuals. Through a close analysis of Simmel's ideas, we can see the relationship of public health with social structural studies of medicine in theoretically innovative ways.