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Transforming general practice: the redistribution of medical work in primary care

Transforming general practice: the redistribution of medical work in primary care
Transforming general practice: the redistribution of medical work in primary care
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.
primary care, professional identity, redistributing work, categorising patients, patient-centred care
0141-9889
71-92
Charles-Jones, Huw
51ed2951-85c7-4a2b-be3a-bf3f1d583c7d
Latimer, Joanna
80de7f82-b6c2-4005-8630-fc3ff6275874
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Charles-Jones, Huw
51ed2951-85c7-4a2b-be3a-bf3f1d583c7d
Latimer, Joanna
80de7f82-b6c2-4005-8630-fc3ff6275874
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4

Charles-Jones, Huw, Latimer, Joanna and May, Carl (2003) Transforming general practice: the redistribution of medical work in primary care. Sociology of Health and Illness, 25 (1), 71-92. (doi:10.1111/1467-9566.t01-1-00325).

Record type: Article

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.

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More information

Published date: January 2003
Keywords: primary care, professional identity, redistributing work, categorising patients, patient-centred care

Identifiers

Local EPrints ID: 163463
URI: http://eprints.soton.ac.uk/id/eprint/163463
ISSN: 0141-9889
PURE UUID: aa1794d1-1b4c-439b-bfcd-0ea460da355d
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 08 Sep 2010 15:05
Last modified: 14 Mar 2024 02:05

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Contributors

Author: Huw Charles-Jones
Author: Joanna Latimer
Author: Carl May ORCID iD

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