Ceremonies
Even if we are able to regard the doctor–patient relationship in terms of power, it may still seem strange to think of our work in terms of ceremonies. Yet there are social scientists who commonly use this word to describe what goes on in medicine. They use it in a special sense, following the leading sociologist of institutions, Erving Goffman. When Goffman talked about ceremonies, he was referring to the way that institutions and their members implicitly impose a set of rules to instruct people how to behave.
One outstanding piece of medical research that applied this approach was Philip Strong's study of paediatric clinics entitled 'The Ceremonial Order of the Clinic'. Strong examined consultations with parents and asked questions, including: 'Who has the right to criticise what is happening, what type of criticism is allowed, who has rights to the overall control of the interaction, and how far are topics and speaking rights pre-allocated?' Not surprisingly, his research showed that the doctors gave strong indications to parents about what it was legitimate to express in consultations about their children. The doctors were also the arbiters of what parents were allowed to consider as appropriate conduct in relation to their children, irrespective of whether this fell within the realm of medical expertise or not.
Although Strong didn't draw an explicit analogy with the priesthood or with formal religious ceremonies, it isn't hard to see from his description how many of the traditional activities of the clergy have actually been re-assigned to doctors. If this seems improbable, you only have to think of the way that patients are lined up in many waiting rooms like a congregation at prayer, even facing the reception desk as if it was an altar. And when doctors emerge every few minutes from consulting rooms to retrieve a set of notes and then vanish again, it has a close resemblance to a Greek orthodox priest disappearing behind the icon screen, or the high priest of the Israelites entering the Tabernacle. Modern doctors, it seems, have done more than take on the moral function of priests. In the waiting room, they enact priestly forms of ritual as well.