Sociologists have considered hospital as a social system based on bureaucracy, hierarchy and super ordination- subordination. A hospital manifests characteristics of a bureaucratic organisation with dual lines of authority, viz.
image source: melanomainternational.org
Administrative and Professional in teaching hospitals and in some others, many professionals at the lower and middle level (interns, junior resident, senior residents, and registrar) are transitory, while as in others, all medical professionals arepermanent with tenured positions and nontransferable jobs.
In order to continue in an orderly fashion, every social system has to fulfill the functional needs of that system, viz. the need for pattern maintenance, the need for adaptation, for goal attainment and integration.
ADVERTISEMENTS:
In a hospital system, the patients’ needs determine the interactions within the system.
When a patient is cured and discharged, in his or her place a new patient is admitted.
This new patient also demands all the attention and skills of doctors, nurses and others, thus, forcing the essential and reparative components into immediate action, repeatedly as each patient is admitted. Free upward and lateral communication is an important characteristic of any system.
So far as communication within the hospital system is concerned, in fact there is considerable restriction in communication among people in the hospital.
ADVERTISEMENTS:
Doctors communicate freely with doctors, nurses with nurses and patients with each other (if not too ill) and with their relatives, but there is little communication between these groups at the nonformula level.
In the course of interaction among the various units of a hospital social system, tensions and conflicts emerge.
These strains have to be dealt with effectively if the system is to function properly. The system has to develop mechanisms of tension management to cope with such strains.
Integration deals with the problem of morale and solidarity in the hospital social system. Morale is necessary both for integration as well as pattern maintenance.
ADVERTISEMENTS:
Integration has to be achieved at the micro level. It involves the development of loyalty to the system, to its other members and the values for which the system stands.
Need for pattern maintenance acts as a barrier to upward or lateral mobility of the staff. One occupational group cannot be promoted to the other group, e.g. laboratory technician cannot become nurse and nurses cannot become doctors.
In general, there is a trend in bureaucratization of hospitals, in which hospitals are seen to work towards achieving their goals through reliance upon such structural devices as systems of division of labour, an elaborate hierarchy of authority, formal channels of communication, and sets of policies, rules and regulations.
The two lines of authority (viz. administrative and professional) come into conflict, because each group has a different set of values. One is concerned with the maintenance of organisation and the other with providing medical expertise. This leads to interpersonal stress.
As a component part of health system, the first task of the hospital is to reach people all the time at a cost the community can afford.
The concept of hospital as the centre of preventive medicine has enlarged its role enormously.
The primary task of the hospitals is the provision of medical care to a community. However, the hospital has two other important roles to fulfil—to be a centre for the education of all types of health workers, doctors, nurses, midwives and technicians and for the health education of the people.