Short report Simmel’s dynamic social medicine: New questions for studying medical institutions? Daniel A. Menchik Department of Sociology and Lyman Briggs College, Michigan State University, 919 East Shaw Lane, Rm E-35, East Lansing, MI 48825, USA article info Article history: Received 4 July 2013 Received in revised form 5 February 2014 Accepted 11 February 2014 Available online 12 February 2014 Keywords: Medical sociology Theory Knowledge Macrosociology Institutions abstract Over the last half century, changes in the structure of medicine have shifted the relationship between the profession of medicine and social institutions. In this paper, I uncover ideas for retheorizing this rela- tionship by analyzing a review by Georg Simmel that has been previously overlooked. In an analytical overview and critical appraisal of Simmel’s text, I argue that he considered preventative medical knowledge more influential when this knowledge is located outside the physicianepatient relationship. Simmel suggests we need to identify how such knowledge is injected into medical and non-medical settings by the mixtures of professional-, market-, and state-based institutions governing medicine, and pay attention to how these institutions shift. His goals show continuity with a social medicine movement in Germany previously thought to be stalled, and are unique too in their focus on targeting institutions over individuals. Through a close analysis of Simmel’s ideas, we can see the relationship of public health with social structural studies of medicine in theoretically innovative ways. Ó 2014 Elsevier Ltd. All rights reserved. In his 1897 review of German physician Arthur Sperling’s Social Medicine, Georg Simmel seized on an environment of social reform to advance a view of health care that has important consequences for interpreting medicine today. 1 In this paper, I draw on Simmel’s lucid review to unearth some of his ideas on the social organization of health and medicine. “Georg Simmel on Social Medicine” has not been cited in a journal since 1969, when a translation was published in Social Forces. 2 This oversight indexes a more general one. It is common for scholars to look to sociology’s heritage: to Marx for explaining power imbalances in the physician-patient encounter, to Engels for describing the relationship between poverty and health, to Weber for interpreting lifestyles and health behaviors, and to Durkheim for identifying anomic features of social organization (e.g., Waitzkin, 1979; Williams, 2003; Cockerham et al., 1993; Wray et al., 2008). While Simmel has inspired sociologists to underscore the importance of connectedness to well-being, relative to other clas- sical thinkers, he is rarely invoked by social scientists who study medicine. 3 In the same way that the growth of organizational sociology has been stunted by looking to management scholarship for its central questions (Scott, 2004: 16), Simmel would argue medical sociology has been limited by the questions posed by members of the medical profession. From his perspective, we would benefit if we distanced ourselves from these questions, and explicitly reframed them into sociological analyses of knowledge, expertise and authority. The perils Simmel described of recasting sociological problems in the E-mail address: mench@msu.edu. 1 Simmel’s review was first published in Die Zeit in 1897; Casparis and Higgins (1969) provide a translation in Social Forces. 2 Although it may seem unsurprising that a book review would go uncited, scholars of intellectual history have recently argued that such reviews should be seen as central venues for scholarship (Muller, 2003: 27e40). There is reason to think this is indeed something Simmel had in mind; since the expansion of review journals at the end of the seventeenth century, the review article was considered a key way to gain attention for one’s ideas in the then-escalating level of competition in scholarly culture (Gierl, 1997). And only one year before Simmel’s piece did Durkheim introduce the book review into the Annee Sociologique, “as a weapon to try to impose the sociology redefined through the Durkheimian concepts in the field of human studies in France,” with reviewers charged with reading a specific set of books and interpreting them through a sociological frame (Muller, 1997: 173). 3 Simmel’s relative absence can be viewed in the archives of two central journals in medical sociology. In a full-text JSTOR search of Social Science & Medicine, there were 31 articles mentioning him, and 979 mentioning Marx, Weber, or Durkheim. The numbers in the Journal of Health and Social Behavior are, including reviews, 21 and 204, respectively. The most frequent subjects in these pieces do not involve the social organization of medicine, and rather address, respectively, the relationship between context and psychological health, and between context and individual health-related actions. In one of few Simmel-inspired pieces on health for a general sociological audience, Pescosolido and Rubin’s (2000) rereading of The Web of Group-Affiliations is notable for the range of implications it yields for the study of mental illness. Contents lists available at ScienceDirect Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed http://dx.doi.org/10.1016/j.socscimed.2014.02.011 0277-9536/Ó 2014 Elsevier Ltd. All rights reserved. Social Science & Medicine 107 (2014) 100e104