Breaking the Ceremonial Order: Patients' and Doctors' Accounts of Removal from a General Practitioner's List
Опубликовано на портале: 05-12-2006
Sociology of Health and Illness.
2006.
Vol. 28.
No. 5.
Тематический раздел:
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 the analysis is extended through recourse to Bourdieu's
theory of practice, by juxtaposing 'paired' accounts of the same removal event by
both remover and removed. The 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. The authors 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.
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