Three sociologists-Talcott Parsons, Eliot Freidson, and David Mechanic-have explained medical phenomena within a broader theoretical framework. Although all three have made significant contributions, their conclusions remain incomplete on the theoretical level and seldom have been helpful for workers concerned with ongoing problems of health care. Our purpose here is to summarize some of the strengths and weaknesses of each theoretical position. Parsons has elucidated the sick role as a deviant role in society, the function of physicians as agents of social control, and the normative patterns governing the doctor-patient relationship. The principal problems in Parsons' analysis center on an uncritical acceptance of physicians' social control functions, his inattention to the ways in which physicians' behavior may inhibit change in society, and overoptimism about the medical profession's ability to regulate itself and to prevent the exploitation of patients. Viewing medical phenomena within a broader theory of the professions in general, Freidson has formulated a wide ranging critique of the medical profession and professional dominance. On the other hand, Freidson's work neglects the full political implications of bringing professional autonomy under control. Mechanic's conceptual approach emphasizes the social psychologic factors, rather than the institutional conditions, which are involved in the genesis of illness behavior. Mechanic also overlooks the ways in which illness behavior, by permitting a controllable form of deviance, fosters institutional stability. In conclusion, we present a brief overview of a theoretical framework whose general orientation is that of Marxian analysis. Several themes recur in this framework: illness as a source of exploitation, the sick role as a conservative mechanism fostering social stability, stratification in medicine, and the imperialism of large medical institutions and health-related industries.
