Social medicine

Social Medicine describes and analyzes the various interactions between health and disease, their risk and protective factors on the one hand and social facts on the other hand under etiological, preventive, rehabilitative, in peer review, supply legal and economic perspective. It is concerned to scientifically and practically with the health of the population and its determinants, the organization of health care and social security, and the effects and costs of medical care. According to Diehl, Gebauer and Groner, the social medicine not only an interdisciplinary subject in medicine is, but also a ' bridge compartment to other disciplines - especially social law, sociology, social work, psychology, statistics and health economics. "

Field of activity

In the socio-medical research, for example, by the social environment -related causes of illness and disability as well as the interaction between social class studied ( social structure ) and health. The further development of public health organizations and the social security institutions represent important socio-medical research areas

Is working as socio-medical expert specialist with additional qualification in Social Medicine created its advice in the field of tension between the partly justified ( for handicapped children), some unauthorized ( pension desire without adequate disease) interests of the individual on the one hand and the interests of solidarity (ie the payer ) on the other. He shall be able to not only have in-depth knowledge of medicine (6 -year medical school, 5 years of specialist training, additional training Social Medicine ) for assessing the impairment amount due to the disease, but also a working knowledge of legislation and case law ( additional qualification in Social Medicine ).

Typical in social medicine to verification questions concern, for example, statements about the extent and expected duration of incapacity for work for positive and negative power image (like only 3 to 6 hours working capacity per day, up to 5kg of lifting or carrying, any activities in awkward postures such as squatting ), limitations on the use of ability to care or to the requirements for recognition of a severe disability.

Specialists with additional qualification in social medicine (see further ) are typically active at MDK / MDS in the statutory pension insurance, the social medical service of the Federal Miners, the supply works, or in rehabilitation facilities.

Classification

In medical studies, the social medicine belongs to the ecological material area in the clinical section. For ecological material area include:

• Occupational Medicine,
• Social Medicine,
• Hygiene,
• Biometry / Epidemiology / Medical computer science and
• Forensic Medicine.

It teaches social medicine in the courses of study social work, health promotion and management and social economy.

Distinction between

To be differentiated social medicine from the Medical Sociology, considered medical action and health behavior in a social context. Robert Straus has brought this difference to the formula: " Sociology of Medicine " = Medical Sociology and " Sociology in Medicine" = Social Medicine. This distinction is thus based on the ambiguity of the genitive object in English and German. Straus emphasized this distinction a medical sociology in terms of accreting from outside science in the " object" of medicine whose " organizational structure, role relationships, value systems, traditions and modes of medicine as a system of behavior ." Johannes Siegrist points to the importance of a research approach, which itself makes for the medical treatment on the subject matter and " by a number of disease conditions and therapeutic results as iatrogenic products " identifies. The currently rather controversial collaboration between established social medicine and medical sociology can be regarded only as a task of case- specific conflicts and remain so reserved in scientific and systematsicher respect of future development. The primary aim of the Medical Sociology coincides partly consistent with the → Sociology, see below chap. Critique of social medicine.

Further education

Doctors can acquire the additional designation Social Medicine in the further education regulations since the decision taken at the 87th German Medical Assembly in 1984 decision to begin Social Medicine. The additional qualification in social medicine includes according to the current model further training of Procedure of the German Medical Association "in addition to a medical specialist competence, the assessment of the nature and extent of health disorders and their impact on the performance of professional and social environment, including the classification of functioning, disability and health, the classification in the framework social security systems and the advice of the social service providers in matters of medical care. "

Scientific Society

The German Society for Social Medicine and Prevention ( DGSMP ), a member company of the Association of the Scientific Medical Societies in Germany ( AWMF ) sees itself in Germany as the scientific society for issues of social medicine. Furthermore, there is scientific activities in the social itself Those are the Professional Association of German social insurance physicians (BSD ) coordinates.

International

Internationally, however, there are very large differences between the different countries. In the Netherlands, for example, social medicine is an umbrella term which includes occupational medicine, insurance medicine and doctors from the public sector. Insurance physicians from the UWV ( the Dutch social security ) for example, must go through a separate 4-year residency training. In Austria, in turn, the social medicine is purely employed in academia and has more the work of a Master of Public Health ( MPH ) to fulfill. The Austrian colleague also has no contact with patients. However, there exist very few specialists and the specialist direction threatened with extinction.

Criticism

Critique of social medicine is pronounced only rudimentary in Germany. It is argued that the social medicine was coined by the famous in the Third Reich JF Lehmann Verlag, in essence, traded under the same name until 1998. The workup of the injustice of the Third Reich during the life unworthy of life did not start until late.

As prompted by health and care funds and carried out by the medical service of the health insurance Social Health Assessment by the Social Code is part of the public law, the protection provisions of the European Convention on Human Rights do not apply here. Criticism of the current practice of socio-medical assessment is also expressed in terms of the power of interpretation.