Indiana Consortium For Mental Health Services Research Indiana University

Abstract

Cultural Authority and the Sovereignty of American Medicine: The Role of Network, Class and Community

Bernice A. Pescosolido and Jack K. Martin, Indiana University

According to Paul Starr, in The Social Transformation of American Medicine (1982), the cultural triumph of progressivism, coupled with institutional changes, established a system of authority based in the scientific profession of medicine rather than on any person who claimed to be a doctor or any type of healing based on other theories (e.g., homeopathy). The cultural authority "entails the construction of reality through definitions of fact and value" (13). While Starr rejected earlier notions that popular attitudes translated directly into status and power, he did see public beliefs and opinion as crucial to the growth of cultural authority and its conversion into the control of markets, organizations, and governmental policy (7). From this perspective, cultural authority engenders trust, compels obedience, and fosters legitimacy, thereby increasing public dependence on the profession of scientific medicine. Thus, the American public became willing to embrace and institutionalize the use of regular physicians despite the belief of many Americans that common sense was the best approach to health and healing.