Transforming general practice: the redistribution of medical work in primary care
Open Access
- 1 January 2003
- journal article
- Published by Wiley in Sociology of Health & Illness
- Vol. 25 (1), 71-92
- https://doi.org/10.1111/1467-9566.t01-1-00325
Abstract
The paper focuses on the redistribution of medical work within primary health care teams. It reports the results of the analysis of interviews with general practitioners, practice nurses and managers, undertaken as part of an ethnographic study of primary care organisation and practice during a period of rapid organisational change. By examining the ways in which the respondents account for how work is being redefined and redistributed, we explore how current government policy and professional discourses combine to reconfigure both the identities of those who work in primary care and the nature of patienthood. In particular, we show how general practitioners are being reconfigured as medical specialists or consultants in ways that seem to depart radically from earlier claims that general practice is a distinctive field of social or biographical medicine. Within this new discourse medical work is distributed between doctors, nurses and unqualified staff in ways which make explicit the reduction of general practice work to sets of biomedical problems or tasks. At the same time, the devolution of much general practice work to less qualified and cheaper personnel is justified by drawing on a discourse of person‐centred medicine.Keywords
This publication has 12 references indexed in Scilit:
- Rethinking the doctor-patient relationship in general practiceHealth & Social Care in the Community, 2007
- 10.1037/e363212004-001Crossref Listing of Deleted Dois, 2000
- GPs and Contracts: Bringing General Practice into Primary CareSocial Policy & Administration, 1999
- Giving patients a future: the constituting of classes in an acute medical unitSociology of Health & Illness, 1997
- The Confidential Patient: The Social Construction of Therapeutic Relationships in General Medical PracticeSociological Review, 1996
- Expert medical decisions in occupational medicine: a sociological analysis of medical judgmentSociology of Health & Illness, 1994
- The construction of medical disposals Medical sociology and medical problem solving in clinical practiceSociology of Health & Illness, 1992
- Categorization in accident departments: ‘good’ patients, ‘bad’ patients and ‘children’Sociology of Health & Illness, 1983
- Normal rubbish: deviant patients in casualty departmentsSociology of Health & Illness, 1979
- The Doctor, His Patient, and the IllnessThe American Journal of the Medical Sciences, 1957