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On Practices of 'Good Doctoring': Reconsidering the Relationship between Provider
Roles and Patient Adherence
K.Lutfey
Sociology of health and illness.
2005.
Vol. 27.
No. 4.
P. 421-447.
Questions pertaining to patient adherence and provider roles are part of the classical
repertoires in sociological and health services research. While extensive research
programmes consider why patients do not follow medical advice, less is known about
how practitioners assess patient adherence. Similarly, there has been much work on
provider roles changing with the organisation of healthcare, but less attention to
the ways providers conceptualise, choose and strategically enact practices in the
course of their work. Using data from a year-long ethnographic study of two diabetes
clinics, the author examines some of the stances medical practitioners actively choose
and enact in their treatment of diabetes patients – educators, detectives,
negotiators, salesmen, cheerleaders and policemen – and how they tailor their
actions to specific patients in order to maximise their adherence to treatment regimens.
Findings suggest that the notions of 'patient adherence' and 'physician roles' are
conceptually broader and more fluid than what is captured in existing literature,
and this rigidity potentially impairs our ability to learn more about the everyday
practices of medical work.
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