This document provides an overview of rational choice theory and exchange theory. Rational choice theory assumes that individuals make rational decisions by weighing costs and benefits to maximize personal gain in a self-interested manner. It has three main assumptions: completeness, transitivity, and independence of irrelevant alternatives. Exchange theory applies rational choice theory to social interactions, assuming individuals rationally analyze rewards and punishments to determine behavior and form relationships. Both theories have been criticized for oversimplifying human behavior and interactions.

1. Rational Exchange Theory
so here we are going to talk about rationalchoice theory and exchange theory. Both center
on economics. Ithas long been assumed that people are motivated by money. Get the most for
your money, right? Then some sociologists theorized that people were motivated by is what is
best for them in all their actions, and that their actions were shaped by their desire for more,
rather than less, of something good. This led to the development of rational choice theory.
The main assumption behind rational choice theory is the idea that everything people do is
fundamentally rational. Rationality here means that a personis acting as if they were
weighing the costand benefits of possible actions so that they can maximize their personal gain.
Rationality is a property of a series, or a pattern of choices, not an individual choice. So
basically, people act in self-interest. They are driven by personal desires and motivated by
personal goals. They calculate the costs and benefits of every action and choosethe one with
the best outcome for themselves. And how do wecalculatethe valueof these actions? How
do we know whichanticipatedoutcomeswillbenefitus the most? Well, we look at the social
resources being exchanged. Like time, information, approval, and prestige to determine the
value of a possible action. Through the individual rational actions of people, rational choice
theory assumes that you can explain complex phenomenon like socialchange andsocial
institutions. Let's take a look at the three assumptions underlying rational choice theory. First
is the assumption of completeness,which means that every action can be ranked. If there are
three possible actions I can take, completeness means that none of the options have an equal
value to me. A is preferable to B and B is preferable to C. And that C is not then preferable to

2. A because that would be circular and irrational according to our definition. This leads to the
secondassumption: transitivity. This means that if we take a look at those three options I
have, since A is preferable to B is preferable to C, then A is also preferable to C. It's like in
math. A is greater than B is great than C, therefore, A is greater than C. The last assumption
is calledindependence of irrelevant alternatives. That's just a big fancy way of saying that, if
I suddenly have a fourth option, X, that it won't change the order of how I ranked the first three
options. I already have A is better than B is better than C. If X is better than C but worse than
B, B isn't suddenly going to be preferable to A. A is still my best option. These three
assumptions result in a consistent, rankable set of possible actions.
All right so now that we have an idea of rational choice theory, let's takes a look at exchange
theory. Exchange theory is an application of rational choice theory to social interactions. It
looks at society as a series of interactions between individuals. And is often used to study
family relationships, work relationships, partner selection, parenting, and many other
interpersonal interactions. These interactions are determined by weighing the rewards and
punishments of every interaction. If the interaction results in approval, it is more likely to be
repeated. Becausesocial approvalis a reward. But if the interaction results in a punishment,
like social disapproval, it is less likely to be repeated. This may seem pretty obvious to you,
that, you'll do something to get a reward, while you'll avoid something that will wind up in
punishment. But this is the basic principle behind exchange theory. That the behavior of
an individual in an interactioncan be figured out by comparing the rewards and the
punishments. Rewards canbe socialapproval, recognition, money, gifts, or positive

3. gestures, like a smile. While punishmentsconsist of social disapproval, public humiliation, or
negative gestures, like a frown.
There are quite a few assumptions that exchange theory depends on. Let's see if I can get
through these quickly and clearly. First, people seek to rationally maximize their profits.
Which means they seek rewards and avoid punishments, right? So, like when you were a kid,
you behaved yourself so you could get a cookie after dinner instead of being sent to your room.
Then there is the assumption that behavior that results in a reward is likely to be repeated. Just
like I mentioned before about rewarding interactions being repeated. But what is interesting is
that exchange theory assumes that the more often some reward is available, the less value that
reward has. Kind of like supply and demand, when supply is too high, the price goes down.
Next it is assumed that interactions operate within the social norms. Keeps our frame of
reference manageable. And just like rational choice theory, exchange theory assumes that
people have access to the information they need to make rational choices. That's probably
debatable, but for the sake of this theory it is assumed. It is also assumed that most human
fulfillment comes from other people. The need for other people comes from the importance of
interdependence and social exchange, but what makes this all even a bit more complicated is
you have to assume that the standards people use to evaluate interactionto change over
time. And that they are different from personto person. What is seen as a reward to one
personmight be a punishment to another person. Phew, all right, assumptions out of the way.
So, we have these interactions that make up society, but exactly what kind of interactions are
they? Well, central to social exchange are the concepts of self-interestand interdependence
that guide human interactions: we form relationships in order to benefit ourselves and because

4. we depend on other people to live. Most people in our modern society cannot be completely
self sufficient. And by that I mean, we can't go off into the woods alone and expect to survive
for any extended period of time. We analyze our interactions with other people and form
relationships based on our own subjective interpretation of whatthe rewards and punishments
of each interaction are. And we base our subjective ideas of our interactions on the social
expectations of what behavior is acceptable. Which is in turn determined by society's rules,
norms and values. There are, of course, criticisms of rational choice theory and social change
theory. Thefirst one that popped into my head was, seriously, do we really make rational
choices? We often do things that aren't rational. For example, why do I eat Ramen noodles,
when I know it's really not good for me, and I can make myself something that actually tastes
better in the same amount of time? I'm not really sure how to answer that one. There's some
people whose choices are limited by social factors like gender, or ethnicity or social class that
pressures them to make a choice that isn't in their bestinterest. Against rational choice theory
in specific, some critics asked that if people always seek to benefit themselves, why would
anyone do something that benefits others more than themselves? It contradicts the main idea
that people are motivated by what is best for them. Then there is the question of why some
people follow social norms that cause them to act in the best interests of other people. Like,
paying taxes or volunteering. The third main criticism is that, is it really possible to explain
every single social structure by the actions of individuals? Critics of exchange theory dislike
that it reduces all human interactions to a rational process ofcomparing pros and cons. It
also tries to put the formation of relations into a linear process, butthat isn't always linear.
Critics point out that relationships can move backward or jump ahead. Rational choice theory

5. and exchange theory attempt to explain society through individuals and interactions. They
assume people make rational choices based on evaluating the rewards and punishments of
interactions. And that behavior is guided by self-interest and interdependence.
Socialtheories overview (part 1)
I know all these social theories can seem pretty daunting. But they're actually fairly simple to keep
track of if you remember the main points. The first theory of society that I'll review is functionalism.
This theory looks at how a society can exist and survive over time. Basically, functionalism states
that a society is always trying to come to an equilibrium, trying to stabilize. The structures that make
up a society, like institutions, will remain pretty constant and only change if absolutely necessary
when the society loses stability. Remember that institutions are structures that fulfill the needs of
society. There's an example of that in our society right now. The business institution has had to
adapt to the huge online shopping boom as online retail providers like Amazon draw more and more
people away from retail stores down the street. Those stores had to find ways to attract people
again so they will take the time to stop in and shop. But it takes a lot of energy to change, so the
stores will only do what is absolutely necessary to get customers again. Right, so when you think of
functionalism, think of the minor changes an institution makes to find a stable balance in the society.
Only change to be functional again. The next theory is conflict theory, which is just like it sounds. It
focuses on how societies change and adapt over time through conflict. In any society, there's going
to be conflicting viewpoints and beliefs, and people are going to take sides. Eventually, this is going
to polarize the society, where one group is happy with the status quo, and another group wants
change. This is a very fragile state for the society, and eventually, both sides will have to come to
some sort of agreement or else tear the society apart. The class struggle in th century Europe is an
example of this process. The workers wanted change, while the factory owners were happy with the
way things were. The two opposing positions were merged to create a new society where the

6. workers had slightly more power than before and the factory owners had slightly less. And everyone
was content, if maybe not ecstatic about the outcome. OK, so in conflict theory, you have two
opposing sides at odds with each other that eventually lead to the creation of a new synthesized
society-- conflict creating a new society. Next, we have the theory of social constructionism which
looks at what a society is rather than how it exists or changes. In social constructionism, everything
is created from the mind of the society. There's an agreement that something has meaning and value
that the thing doesn't actually have intrinsically. One of the most prevalent examples today is money.
It has no value on its own. It's just paper or metal or numbers in a computer. But as a society, we
have agreed to give it a specific value. And that agreement actually helps to shape the society itself.
So when you think of social constructionism, remember that everything only has value because we
agree it has value. We construct the world around us. The final social theory here is symbolic
interactionism. This one is kind of different than the other theories because it puts a lot of focus on
the individual and how they behave. It is based around the idea of the meanings we give to things.
Like, to me, a tree could be a source of shade, whereas for someone else, it could be home to
spiders and ants. People are created by their society. They act based on their past experiences in
their lives and the meanings they have given things. But not everyone gives the same meaning to
everything. That tree could mean different things to different people. And even if you just look at
one person, a tree could have multiple meanings. And those meanings can even change over time.
The meanings we give things is based on our past experiences in society, and those meanings and
our interpretations create our future society. To put it in a phrase, symbolic interactionism says that
we interact with the world to give it meaning. So to sum up this summary, we have functionalism
looking at the stability of the society, conflict theory looking at how the society changes, social
constructionism discovering how things are given value, and finally symbolic interactionism learning
how individuals act

7. SocialTheories PartII
Here is part two of our social theories overview. I'll quickly sum up feminist theory and rational exchange theories, and
you can be on your way. Feminist theory is a macro level, or a big world perspective on society. It focuses on the gender
inequalities inherent to patriarchal capitalist societies. In patriarchal societies, men occupy the governing positions, both in
the families and in the community at large. Women are marginalized, objectified, oppressed, subordinated and
discriminated against. Though, it isn't always apparent. Both women and men are often forced into socially acceptable
gender-based roles. The difference is that men are not subjugated because of their categorizations. Feminist theory can
focus on the effects of socially constructed gender differences, like how women's experience and social position in social
situations differs from mens'. And the different values associated with femininity and masculinity. It can also focus on
gender inequalities, where women’s subordination is viewed as an inherent feature of society, because of the way
institutions are structured. There’s also gender oppression, where women are not only viewed as unequal to men, but
they are actually oppressed and even abused because of it. And structural oppression that views women's subordination
as a result of capitalism, patriarchy and racism. Feminist theory does not attempt to replace men at the top of the social
ladder, but rather to shed light on the gender inequalities ingrained in our society, in the hopes of achieving equality.
Rational choice theory basically states that people always take rational actions, weighing the costs and benefits of each
action so that the outcome benefits them the most. A rational choice is part of a pattern of choices that are consistent.
Rational choice theory makes three main assumptions. One, completeness, that all actions can be ranked. Two,
transitively, that if A is preferable to B, and B is preferable to C, that A is also preferable to C. And three, independence of
irrelevant alternatives. That if an additional choice is available, it won't change the relative ranking of the previous choices.
If I suddenly have option X, B isn't abruptly better than A. All of this adds up to explain how people choose the best
possible option for themselves out of the available selections. Exchange theory is the application of rational choice theory
to social interaction. It is used to study family relationships, work relationships, partner selection, parenting and many
other interpersonal interactions. There are many assumptions associated with exchange theory, but basically they state
that people behave with the goal of maximizing their own rewards while minimizing the punishments. That people have
the information they need to make rational choices, within social norms. That self-interest and interdependence guide
human interactions. And, that human relationships are formed, because people analyze their interactions using cost-
benefit analysis. And along with all that, you have to consider that the standards of what is a reward and what is a
punishment, change over time. And, are different from person to person. Society is made of these interactions between
people who will behave according to a subjective analysis of rewards and punishments of each possible interaction. There
are criticisms of rational choice theory and exchange theory. The first I thought of was, if people actually make rational
choice, I certainly don't always, critics ask why anyone would do something to benefit someone else more than

8. themselves. Why would someone follow social norm that were not in their own self-interest? And can you really explain
ever social structure through the interactions of individuals? They also criticize the reduction of human interactions
through a rational process. And the linearization of forming relationships, when it often feels more like a carnival ride of
twists and backs and jumps. And, there we have it. That's feminist theory and rational exchange theories. Pretty
straightforward, right?
Relationof SocialTheories to Medicinne
When you step back and look at the sociology content here, you might be wondering how in the world any of this applies
to medicine. You might say, it has nothing to do with the physical health of a person, so why do you need to know all of
this? Why do these social theories and social structures matter to someone in the field of medicine? Let's go through the
different theories and figure this out.
First off, we have functionalism. Remember, functionalism is the theory that different institutions in a society adjust to
minor changes to keep the society stable and functioning. If we look at the function of medicine in society from a
functionalist point of view. We're asking what is the purpose of medicine. Well when people become ill medicine ensures
that they return to a functional state, so they can contribute to society. Being sick is detrimental to the well being of the
society as a whole and when you're sick people can usually tell. They tell you to go home and get better. The assumption
is that you're not supposed to participate in society when you're sick. This upsets the stability of the society on a small
scale at least. The doctor is there to get you better again, so you can get back to participating in society.
On a bigger scale, the institution of medicine helps us stabilize the social system in emergency situations like hurricanes
or earthquakes, where hospitals and medical professionals take over large spaces like school gyms to provide the
medical assistance needed by the many people who are injured.
In day-to-day life medicine helps to improve the quality of life for the aging population, allowing them to contribute to
society for longer. Okay, that seems to make sense. Medicine keeps people healthy and participating in society.
What about conflict theory? How do conflicting groups in a society affect the health of an individual? As we know,
conflict theory is all about the inequality between different groups. In the case of medicine, this could have quite a
significant impact on who has access to medical care, meaning both access to hospitals and the ability to be covered by
insurance. Wealthier citizens can pay for the best medical care, but people that are scraping by cannot afford hospital bills
without insurance. Sometimes people can afford health insurance when it isn't provided by their employer or they can't

9. afford the deductibles, so they skip the hospital visit and try to heal on their own. Meaning they are sick for longer or
perhaps they never get better.
The unequal access to valuable resources in society, like education, housing or well-paying jobs, leads to health
disparities and limited access to medical care. Even the power struggle between different interest groups can affect
the health of an individual. Take a look at air pollution regulations. Factories want more lax regulations to reduce costs,
while the people living near those factories want stricter regulations for their own health and well being. Asthma rates rise
in areas with higher levels of particulate matter in the air. Stricter air pollution regulations keep the residents healthier, in
terms of asthma rates at least, but put a dent in the income of factories.
All right, two down. Let's take a look at the theory of social constructionism now. In case you forgot, social constructionism
is the idea that society gives value to everything. A diamond was just a rock until society agreed that it should have value.
In regards to medicine, it means that as a society, we have attached different meanings to different behaviors, and we
have different preconceptions of different people. In short it means stereotypes, we have assumptions about people
based on their appearance or actions and we treat people differently because of those assumptions. We have
preconceptions about different races, ages, genders, even subcultures like medal heads. In the past, if we saw someone
talking to themselves on the street we would assume they were mentally unstable so we would give them a wide berth.
Today, we know people might be talking on a Bluetooth device and so we assume they aren't crazy. Assumptions can be
very dangerous to a medical professional. They can affect how you treat your patient or your diagnosis. But interaction
between the patient and the doctor is influenced by stereotype assumptions on both sides. Perhaps the patient feels
some symptom is not important enough to mention to the doctor or perhaps the doctor makes a false assumption based
on how the patient appears. Assumptions also affect how the health system views the patient. There are people who
argue that someone who can't afford health care doesn't deserve it because they don't work hard enough. You can't
declare a characteristic of a person based on their circumstance. There are people who don't work who can still afford
health care, while some people work hard at minimum wage who can't spare the money. You also have to be aware of
medicalization, where patients or doctors will construct an illness out out ordinary behavior. A child who can't sit still in
class doesn't necessarily have ADD. They might just need to get out on the playground and run.
Now that we know to be aware of social based assumptions, let's check out how symbolic interactionism applies to
medicine. Remember the symbolic interactionism states that individuals give the world meaning by interacting with it.
One person could consider a bridge a way to cross over a body of water, while another person considers it a good shelter
from the rain. There are many ways we can see how this applies to medicine. Let's take a look at two. For one, we have
the doctor-patient relationship. The meaning given to simple objects, like a lab coat or a stethoscope, can affect the
interaction. It is important for the doctor to realize the meaning the patient's given to the tools of medicine. The patient

10. may see the lab coat as a sign of authority, giving the doctor the power to diagnose and treat them. Is the stethoscope a
way for the doctor to connect with the patient, or is it just a tool that decorates a doctor's neck? Second, we have the
changes in society. Recently, there has been a medicalization of society, where everything from beauty to just being
fidgety now has a medical fix. Standards of beauty have encouraged many people to undergo unnecessary plastic
surgery. People can choose to have C-sections when giving birth. Which can effect both the mother and child
later in life. Normal behaviors are being shown as illnesses. One of the most prevalent examples of illness
manufacturing is in the case of depression.
While depression is a serious condition it's importance and severity have been marginalized. It seems like every other
person today is depressed. When you're sad, society views that as there being something wrong with you, but in reality
sadness is a natural biological function. We're suppose to be sad sometimes. All right, let's take a look at something a bit
more specific.
Feminist theory is an offshoot of conflict theory that focuses on the inequalities between men and women in society.
These inequalities are pretty apparent when looking at the field of medicine. Though the admittance of women into med
school is on the rise, it is still am male-dominated field. The heads of hospitals and doctors in general still tend to be men.
There's a disparity in the jobs and salary between male and female doctors. Men more often occupy higher paid positions.
Women are more often found in family medicine rather than specialized fields. This disparity in health care positions
translates into a disparity in power. If you take a look at medicine from the perspective of rational choice and exchange
theories, you can observe big worldview issues of power. Rational choice and exchange theory assume that people
behave rationally according to their best interests. And that you can break down any social institution into the
self-interest of interactions between individuals. So, let's see how this applies. When you look at the medical system
as a whole, you can ask, what is the purpose of the medical system? Does it really exist to keep people healthy or is there
some other reason? Perhaps it’s a capitalist competition to earn the most money. Perhaps the structure of our medical
system benefits private companies more than it does the sick people that it’s supposed to be helping. People run every
aspect of the medical system and those people will make decisions that benefit themselves more than a random sick
stranger. And perhaps, that effects why people go to the doctor or not when they're sick. Will going to the doctor benefit
them the most in the long run? Or will it cost them an arm and a leg? Some people avoid doctor visits for minor things,
because they can not afford the expense. But that could allow something that could be easily treated to become a much
larger problem. The self interested behavior people in charge of different aspects of the medical system will trickle down
to eventually effect the well being of a patient. Well look at that bridging the gap between sociology and medicine seemed
a near impossible task when we started but now we have quite a few examples. To be honest, there are probably so
many more ways that sociology's involved in medicine. Let's take a look outside the specific theories too. Where you live

11. can affect you health. There are urban areas called food deserts, where there are no grocery stores within a reasonable
distance. The only places to eat are fast food restaurants or, perhaps, grabbing a snack at a gas station. It is nearly
impossible to get the nutrition a body needs from only these sources, and malnutrition can lead to a host of other
problems. Some neighborhoods have no gyms or playgrounds, nowhere for residents to exercise. You can use these
examples to come up with your own examples of other places where sociology applies to medicine.