What Is Social Medicine?

A workshop exploring the practice, teaching, writing and history of Social Medicine and its relevance for Health and Social Justice today and in the future.

Workshop leaders: Matt Anderson and Lanny Smith. We both work in the Bronx as primary care doctors and teach within the Montefiore Residency Program in Social Medicine and at Albert Einstein School of Medicine (emphasis in Global Health). Matt works closely with People Living With HIV/AIDS in Guatemala, runs the Social Medicine Portal (www.socialmedicine.org and www.medicinasocial.org) and lived for eight years in Haiti working with people and honeybees. Lanny is on the Global Steering Group of the People’s Health Movement (www.phmovement.org), helped start Doctors for Global Health (www.dghonline.org), and lived seven years in El Salvador learning and practicing Liberation Medicine. We are co-founders of the peer-review, open-access journal Social Medicine (www.socialmedicine.info) and work together with the Latin American Social Medicine Education Society, ALAMES on the Spanish edition (www.medicinasocial.org) with editors from around the world.

For two hours we will explore aspects of Social Medicine (how it affects the practice of Health Promotion and Primary Care, how it can be taught, how it can be written about and relevant aspects of its history) with the goal of sharing our tools in the discipline with all participants, as well as learning from any of those present who have been active in Social Medicine. Our style will be highly interactive and bilingual. (We are both fluent in Spanish; Matt is also able to converse in French and Haitian Creole.)

What is Social Medicine?
It is possible to argue that all medicine by its very nature is social. The way we define diseases and health, the methods we use for diagnosis and treatment, how we finance health care, all these cannot help but reflect the social environment in which medicine operates.
Social medicine, however, looks at these interactions in a systematic way and seeks to understand how health, disease and social conditions are interrelated. This type of study began in earnest in the early 1800's. It was the time of the Industrial Revolution and it was impossible to ignore the extent to which the factory system impoverished the workers, thus creating poverty and disease.
The most famous representative of early social medicine is Rudolf Virchow, the distinguished German pathologist who developed the theory of cellular pathology. Virchow was also a social reformer who remarked that "politics is nothing more than medicine on a grand scale." In the 20th century George Rosen would distill the Virchow's principles into the following:
1. Social and economic conditions profoundly impact health, disease and the practice of medicine.
2. The health of the population is a matter of social concern.
3. Society should promote health through both individual and social means.
As might be gathered from these ideas, social medicine was not simply an academic pursuit. Its practitioners were political reformers, radicals, activists. Virchow believed that the "physician was the natural advocate for the poor." And this defense of social justice would stamp future generations of physicians and health care workers.
Social medicine has grown and developed in many different ways in the past two centuries. At times it has seemed as if the "biomedical paradigm" would make social issues in medicine irrelevant. Yet we cannot escape the reality that we are social animals and our diseases occur in "social animals" and not in test-tubes. The current debate over HIV treatment access illustrates both the astounding success and spectacular failure of modern biomedicine. Why is it that most AIDS patients will simply not get the medications that can save their lives? What would Virchow have said?