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Rethinking collegiality: Restratification in English general medical practice 2004-2008

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  • McDonald, Ruth
  • Checkland, Kath
  • Harrison, Stephen
  • Coleman, Anna

Abstract

For Freidson [(1985). The reorganisation of the medical profession. Medical Care Review, 42(1), 11-35], collegiality, or ostensible equal status amongst members of the medical profession, serves a dual purpose. It socialises members into an attitude of loyalty to colleagues and presents an image to those outside the profession that all its members are competent and trustworthy. However, Freidson saw the use of formal standards developed by one (knowledge) elite within medicine and enforced by another (administrative) elite as threatening collegiality and professional unity. Drawing on two studies in English primary medical care this paper reports the emergence of new strata or elites, with groups of doctors involved in surveillance of others and action to improve compliance in deficient individuals and organizations. Early indications are that these developments have not led to the consequences which Freidson predicted. The increasing acceptance of the legitimacy of professional scrutiny and accountability that we identify suggests that new norms are emerging in English primary medical care, the possibility of which Freidson's analysis fails to take account.

Suggested Citation

  • McDonald, Ruth & Checkland, Kath & Harrison, Stephen & Coleman, Anna, 2009. "Rethinking collegiality: Restratification in English general medical practice 2004-2008," Social Science & Medicine, Elsevier, vol. 68(7), pages 1199-1205, April.
    • Handle: RePEc:eee:socmed:v:68:y:2009:i:7:p:1199-1205
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    References listed on IDEAS

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    1. Broadbent, Jane, 1998. "Practice nurses and the effects of the new general practitioner contract in the British NHS: The advent of a professional project?," Social Science & Medicine, Elsevier, vol. 47(4), pages 497-506, August.
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    Cited by:

    1. Bryce, Marie & Luscombe, Kayleigh & Boyd, Alan & Tazzyman, Abigail & Tredinnick-Rowe, John & Walshe, Kieran & Archer, Julian, 2018. "Policing the profession? Regulatory reform, restratification and the emergence of Responsible Officers as a new locus of power in UK medicine," Social Science & Medicine, Elsevier, vol. 213(C), pages 98-105.
    2. Cheraghi-Sohi, Sudeh & Calnan, Michael, 2013. "Discretion or discretions? Delineating professional discretion: The case of English medical practice," Social Science & Medicine, Elsevier, vol. 96(C), pages 52-59.
    3. Drennan, Vari M. & Gabe, Jonathon & Halter, Mary & de Lusignan, Simon & Levenson, Ros, 2017. "Physician associates in primary health care in England: A challenge to professional boundaries?," Social Science & Medicine, Elsevier, vol. 181(C), pages 9-16.
    4. McGivern, Gerry & Fischer, Michael D., 2012. "Reactivity and reactions to regulatory transparency in medicine, psychotherapy and counselling," Social Science & Medicine, Elsevier, vol. 74(3), pages 289-296.
    5. McDonald, Ruth & Cheraghi-Sohi, Sudeh & Bayes, Sara & Morriss, Richard & Kai, Joe, 2013. "Competing and coexisting logics in the changing field of English general medical practice," Social Science & Medicine, Elsevier, vol. 93(C), pages 47-54.
    6. Bernardi, Roberta & Wu, Philip F., 2022. "Online health communities and the patient-doctor relationship: An institutional logics perspective," Social Science & Medicine, Elsevier, vol. 314(C).
    7. Sabina Siebert & Stacey Bushfield & Graeme Martin & Brian Howieson, 2018. "Eroding ‘Respectability’: Deprofessionalization Through Organizational Spaces," Work, Employment & Society, British Sociological Association, vol. 32(2), pages 330-347, April.

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