Johnson T M
Soc Sci Med. 1986;22(9):963-71. doi: 10.1016/0277-9536(86)90169-3.
The culture of American medicine has both central biomedical and peripheral psychosocial traditions, a pluralism which demands further study. Anthropologists have traditionally learned a great deal about any culture by studying the socialization process, and the same is true of medicine. In consultation-liaison psychiatry, the peripheral position of the psychosocial tradition can be better understood as psychiatrists teach students and residents how to assist biomedical specialists in the care of their hospitalized patients. Through such student socialization, the use of the technology of biomedicine by psychiatrists for both the manifest function of patient care and the latent function of cementing interprofessional relationships is revealed. In consultation psychiatry, students are also taught that the object of their ministrations is not the patient, but all members of the ward milieu, a focus which is not characteristic of the biomedical tradition. Students in consultation psychiatry are inculcated with attitudes and values which are divergent from those of the biomedical tradition; the competitive presentation and selective assimilation of such elements of professional ideology by students further betrays the peripheral position of psychosocial concerns in medicine. This position is also highlighted by the teaching of 'survival strategies' to students and residents in psychiatry, designed to increase the likelihood of acceptance by biomedical specialists. These include mimicking biomedical approaches to diagnosis and treatment, viewing biomedical specialists as patients who are unwitting victims who can be cured with the right treatment, manipulating symbols and using metaphors of biomedicine to affirm the basic kinship of all physicians, and otherwise promoting psychiatry as central to modern medicine. Yet, the psychosocial tradition, itself, is not homogeneous.(ABSTRACT TRUNCATED AT 250 WORDS)
美国医学文化既有核心的生物医学传统，也有边缘的社会心理传统，这种多元性需要进一步研究。传统上，人类学家通过研究社会化过程对任何一种文化有了很多了解，医学也是如此。在会诊联络精神病学中，当精神科医生教授学生和住院医生如何协助生物医学专家护理住院患者时，社会心理传统的边缘地位能得到更好的理解。通过这种学生社会化过程，揭示了精神科医生将生物医学技术用于患者护理的显性功能以及巩固跨专业关系的隐性功能。在会诊精神病学中，学生还被教导他们服务的对象不是患者，而是病房环境中的所有成员，这一关注点并非生物医学传统的特征。会诊精神病学专业的学生被灌输了与生物医学传统不同的态度和价值观；学生对这种专业意识形态元素的竞争性呈现和选择性吸收进一步暴露了社会心理问题在医学中的边缘地位。向精神病学专业的学生和住院医生传授“生存策略”也凸显了这一地位，这些策略旨在增加被生物医学专家接受的可能性。这些策略包括模仿生物医学的诊断和治疗方法，将生物医学专家视为不知情的受害者患者，认为可用正确治疗治愈他们，操纵符号并使用生物医学的隐喻来确认所有医生的基本亲缘关系，以及以其他方式宣扬精神病学是现代医学的核心。然而，社会心理传统本身并非同质的。（摘要截选至250词）
