Note: the ranking list includes ovarian cancer but interestingly not breast
University of Oslo, Oslo, Norway. dag.album@sosiologi.uio.no
Abstract
Surveys
have shown that the prestige of medical specialities is ordered
hierarchically. We investigate whether similar tacit agreement in the
medical community also applies to diseases, since such rankings can
affect priority settings in medical practice. A cross-sectional survey
was performed in three samples of physicians and medical students in
Norway in 2002. A questionnaire was sent to 305 senior doctors (response
rate, 79%), 500 general practitioners (response rate, 65%) and 490
final-year medical students (response rate, 64%). Outcome measures were
ratings on a 1-9 scale of the prestige these respondents believed most
health personnel would accord to a sample set of 38 different diseases
as well as 23 medical specialities. Both diseases and specialities were
clearly and consistently ranked according to prestige. Myocardial
infarction, leukaemia and brain tumour were among the highest ranked,
and fibromyalgia and anxiety neurosis were among the lowest. Among
specialities, neurosurgery and thoracic surgery were accorded the
highest rank, and geriatrics and dermatovenerology the lowest. Our
interpretation of the data is that diseases and specialities associated
with technologically sophisticated, immediate and invasive procedures in
vital organs located in the upper parts of the body are given high
prestige scores, especially where the typical patient is young or
middle-aged. At the other end, low prestige scores are given to diseases
and specialities associated with chronic conditions located in the
lower parts of the body or having no specific bodily location, with less
visible treatment procedures, and with elderly patients.
