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Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce
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Martin, Graham P., Currie, Graeme and Finn, Rachael (2009) Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce. Social Science & Medicine, Vol.68 (No.7). pp. 1191-1198. doi:10.1016/j.socscimed.2009.01.006
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Official URL: http://dx.doi.org/10.1016/j.socscimed.2009.01.006
Abstract
Efforts to ‘modernize’ the clinical workforce of the English National Health Service have sought to reconfigure the responsibilities of professional groups in pursuit of more effective, joined-up service provision. Such efforts have met resistance from professions eager to protect their jurisdictions, deploying legitimacy claims familiar from the insights of the sociology of professions. Yet to date few studies of professional boundaries have grounded these insights in the specific context of policy challenges to the inter- and intra-professional division of labour, in relation to the medical profession and other health-related occupations.
In this paper we address this gap by considering the experience of newly instituted general practitioners with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care. Using qualitative data from four comparative case studies, we discuss how an established intra-professional division of labour within medicine—between clinical geneticists and general practitioners—was opened, negotiated and reclosed in these sites. We discuss the contrasting attitudes towards the nature of genetics knowledge and its application of GPSIs and geneticists, and how these were used to advance conflicting visions of what the nascent GPSI role should involve. In particular, we show how the claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary than the rhetoric of modernization might suggest.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Subjects: | H Social Sciences > HD Industries. Land use. Labor | ||||
| Divisions: | Faculty of Social Sciences > Warwick Business School > International Centre for Governance & Public Management Faculty of Social Sciences > Warwick Business School |
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| Journal or Publication Title: | Social Science & Medicine | ||||
| Publisher: | Elsevier | ||||
| ISSN: | 0277-9536 | ||||
| Official Date: | 2009 | ||||
| Dates: |
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| Volume: | Vol.68 | ||||
| Number: | No.7 | ||||
| Number of Pages: | 8 | ||||
| Page Range: | pp. 1191-1198 | ||||
| DOI: | 10.1016/j.socscimed.2009.01.006 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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