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Breaking the ceremonial order: patients' and doctors' accounts of removal from a general practitioner's list
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Stokes, Tim, Dixon-Woods, Mary and Williams, Simon (2006) Breaking the ceremonial order: patients' and doctors' accounts of removal from a general practitioner's list. In: BSA Medical Sociology Conference, York, ENGLAND, 2002. Published in: SOCIOLOGY OF HEALTH & ILLNESS, 28 (5). pp. 611-636. doi:10.1111/j.1467-9566.2006.00509.x ISSN 0141-9889.
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Official URL: http://dx.doi.org/10.1111/j.1467-9566.2006.00509.x
Abstract
The removal of patients from general practitioners' (GPs) lists in the UK offers important sociological insights into what happens when the doctor-patient relationship 'goes wrong'. An interactionist analysis shows how removers (doctors) and removed (patients) strategically invoke 'rules of conduct' to account for difficulties in the doctor-patient relationship and for GPs' decisions to end their relationships with patients. In this paper we extend this analysis through recourse to Bourdieu's theory of practice, by juxtaposing 'paired' accounts of the same removal event by both remover and removed. Our analysis demonstrates the unthinking or non-reflective nature of people's understanding of the rules governing social interactions, but also demonstrates how apparent rule violations make the rules explicit and expose patterns of power distribution. We argue that removal of patients amounts to a strategic exercise of symbolic power by GPs, and that this is experienced as an overtly violent symbolic act by patients. A theoretical reconciliation of interactionist theories of the doctor-patient relationship with Bourdieu's theory of practice is both possible and profitable, providing a micro-macro link in which issues of capital and power within the health (care) field are brought to the fore.
Item Type: | Conference Item (UNSPECIFIED) | ||||
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Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine H Social Sciences H Social Sciences > HM Sociology |
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Journal or Publication Title: | SOCIOLOGY OF HEALTH & ILLNESS | ||||
Publisher: | BLACKWELL PUBLISHING | ||||
ISSN: | 0141-9889 | ||||
Official Date: | July 2006 | ||||
Dates: |
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Volume: | 28 | ||||
Number: | 5 | ||||
Number of Pages: | 26 | ||||
Page Range: | pp. 611-636 | ||||
DOI: | 10.1111/j.1467-9566.2006.00509.x | ||||
Publication Status: | Published | ||||
Title of Event: | BSA Medical Sociology Conference | ||||
Location of Event: | York, ENGLAND | ||||
Date(s) of Event: | 2002 |
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