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Achieving clinical behaviour change: a case of becoming indeterminate

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  • Wood, Martin
  • Ferlie, Ewan
  • Fitzgerald, Louise

Abstract

This paper is based on an empirical study of attempts to achieve change in clinical behaviour across a United Kingdom National Health Service (NHS) Health Authority (HA). We suggest that the evidence based medicine (EBM) movement underpinning such attempts is premised upon a highly rationalistic conception of change. Here the generation and implementation of research findings into clinical practice is understood as movement between discrete entities. Drawing upon poststructural philosophy, social studies of science and technology, social anthropology, and gender studies, we challenge such linear perspectives through a more immanent alternative. We conceive of change as movement within indeterminate or ambiguous relationships. We then proceed to discuss the implications of this modality for the management of clinical behaviour change.

Suggested Citation

  • Wood, Martin & Ferlie, Ewan & Fitzgerald, Louise, 1998. "Achieving clinical behaviour change: a case of becoming indeterminate," Social Science & Medicine, Elsevier, vol. 47(11), pages 1729-1738, December.
    • Handle: RePEc:eee:socmed:v:47:y:1998:i:11:p:1729-1738
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    Citations

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    Cited by:

    1. Moreira, Tiago, 2005. "Diversity in clinical guidelines: the role of repertoires of evaluation," Social Science & Medicine, Elsevier, vol. 60(9), pages 1975-1985, May.
    2. Rhodes, Tim & Lancaster, Kari, 2019. "Evidence-making interventions in health: A conceptual framing," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    3. John Boswell, 2014. "‘Hoisted with our own petard’: evidence and democratic deliberation on obesity," Policy Sciences, Springer;Society of Policy Sciences, vol. 47(4), pages 345-365, December.
    4. King, Gillian & Currie, Melissa & Smith, Linda & Servais, Michelle & McDougall, Janette, 2008. "A framework of operating models for interdisciplinary research programs in clinical service organizations," Evaluation and Program Planning, Elsevier, vol. 31(2), pages 160-173, May.
    5. Rashidian, Arash & Eccles, Martin P. & Russell, Ian, 2008. "Falling on stony ground A qualitative study of implementation of clinical guidelines' prescribing recommendations in primary care," Health Policy, Elsevier, vol. 85(2), pages 148-161, February.
    6. Mykhalovskiy, Eric & Armstrong, Pat & Armstrong, Hugh & Bourgeault, Ivy & Choiniere, Jackie & Lexchin, Joel & Peters, Suzanne & White, Jerry, 2008. "Qualitative research and the politics of knowledge in an age of evidence: Developing a research-based practice of immanent critique," Social Science & Medicine, Elsevier, vol. 67(1), pages 195-203, July.
    7. Rhodes, Tim, 2018. "The becoming of methadone in Kenya: How an intervention's implementation constitutes recovery potential," Social Science & Medicine, Elsevier, vol. 201(C), pages 71-79.
    8. Prosser, Helen & Walley, Tom, 2006. "New drug prescribing by hospital doctors: The nature and meaning of knowledge," Social Science & Medicine, Elsevier, vol. 62(7), pages 1565-1578, April.
    9. Lambert, Helen, 2006. "Accounting for EBM: Notions of evidence in medicine," Social Science & Medicine, Elsevier, vol. 62(11), pages 2633-2645, June.

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