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

Huw Charles-Jones*, Joanna Latimer, Carl May

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)71-92
Number of pages22
JournalSociology of Health and Illness
Volume25
Issue number1
Publication statusPublished - Jan 2003

Keywords

  • Categorising patients
  • Patient-centred care
  • Primary care
  • Professional identity
  • Redistributing work

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