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Technology, Organization & Work: Making the Distal Patient and the Corporate Professional
Professor Carl May - Newcastle University, UK
Over the past three decades, medical sociology in Britain has become steadily more engaged with problems of chronicity. This period began with path-breaking analyses of experiences of illness, biographical disruption, and interactional engagement between patients and professionals. These studies have often been concerned with illnesses in which longstanding distress, disability, degeneration and decline, are locked together with other social problems. These have included, inter alia, asymmetries of power and knowledge, gendered experiences of illness and divisions of labour, ageing and marginalization, and income inequalities and social exclusion. Importantly, narratives of the work that patients and professionals do – in concert and in conflict – to ‘manage’ chronicity have been central to sociological analysis.
This large and growing body work has had a strong reciprocal relationship with health policy: for, in this period – on both sides of the Atlantic – the epidemiological transition from acute to chronic illness, and the demographic transition to an ageing population, have been presented in policy discourse as unwarranted burdens placed upon the healthy younger population, rather than evidence of the triumph of healthcare provision. Since the early 2000s, however, sociologists have also charted interventions that have sought to engender different kinds of disengagement or distantiation between sick people, health professionals, and health services: for example through interventions aimed that making expert patients, the reconfiguration of professional divisions of labour, or through the implementation of telecare systems. This presentation will draw on longstanding programmes of research on chronic disease management and innovations in health technology to address some of the consequences of the technological and organizational reworking of patient-professional relations, focusing on the changing interactions between the burdens of illness and the burdens of treatment, and on the increasingly diffuse boundaries between healthcare and home.
“Carl May is professor of medical sociology leads the Health Technologies and Human Relations research group at Newcastle University. Carl read Social Policy at UCW Aberystwyth. After doctoral work at Edinburgh on nurse-patient interaction, between 1990 and 2000 Carl worked as a post-doc in addictions research (Edinburgh), and then as lecturer (Liverpool), and Reader (Manchester) in Medical Sociology. He has held the chair in medical sociology at Newcastle since 2001, and also holds honorary appointments at Melbourne, Victoria, and the Mayo Clinic. Carl has researched and published widely on the sociology of professional knowledge and practice, especially with reference to chronic pain and discomfort. Over the past decade the main focus of his work has been the sociology of health technologies and health technology assessment, with special reference to telemedicine and telecare systems. An ESRC fellowship (2004-7) provided an opportunity to draw a number of facets of this work together and to develop a middle range explanatory model (Normalization Process Theory) that helps us to understand how the material practices of healthcare become embedded in their everyday contexts, this work being developed in his recent book, co-authored with Tracy Finch, Normalizing Health Technologies (Palgrave, 2010).” |
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The Vicissitudes of the Patient Perspective, Medical Sociology, Health Services Research and Policy
Professor Anne Rogers - University of Manchester, UK
Over the last three decades capturing the patient perspective has featured almost everywhere in health services research and policy. This session will track the way in which the experience and perspectives of patients have become objects of research and policy and practice, the role of medical sociology in fostering this trend and the emergence of a number of paradoxes and tensions in the inclusion of patient involvement in State sponsored health policy initiatives. Drawing on research projects undertaken in the arenas of primary care, mental health chronic conditions the way in which ‘the ‘ patients perspective has resulted a rich stream of applied sociological research illuminating previously hidden aspects of patient need and activities in health and illness matters will be explored. Alongside the seeming success of what can be viewed as a professional and ideological project for medical sociologists the incorporation of the patients perspective into health policy has brought with it unexpected consequences with the translation and incorporation of ‘learning from the patient’ into social engineering projects promulgated by the State. The particular constructions of patient identities and ensuing rhetoric of the latter suggests the need for critical reflection about the ideological and political ramifications of the promotion of research on patient perspectives for medical sociology.
After graduating in Social Sciences (Sociology and Social Policy) from the Polytechnic of Central London in 1984, Anne went on to do an MSc in Sociology as Applied to Medicine at Bedford College, University of London. Subsequently she gained employment as a research officer in the Legal Department of National Mind, exploring the implementation of Section 136 of the Mental Health Act and became interested in a broad range of mental health issues including civil commitment, coercion, drug treatments and user involvement. During that time Anne undertook a part-time Phd at the University of Nottingham exploring notions of professional dominance applied to policing and psychiatry. Between 1985-90 Anne was also a member and Chair of a Community Health Council in South London. Anne worked for a while as a freelance and contract researcher for the National Youth Bureau and undertook part-time tutoring at various London Universities and medical schools until she was appointed to a full time sociology lecturing post at the Roehampton Institute University in 1989. Anne taught medical sociology, research methods and undertook research exploring users experiences of psychiatric services. In 1994, she moved to the North West and joined the University of Manchester, the School of Primary Care and the National Primary Care Research & Development Centre. In 2001 she was promoted to her present position as Professor of the Sociology of Health Care.
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