Physicians are constantly exposed to new medical innovations and ideas via journals and drug representatives, at medical conferences and from other physicians. At the same time they are influenced by norms present in their teams, departments, and networks of colleagues outside of their hospital. Hospital administrators and other non-physicians who fund and support patient care may choose to constrain a physician's autonomy to draw from the latest innovations in a field. Yet we know that medical care changes as a result of new ideas and technical developments. Existing sociological literature does not provide a compelling explanation of how the different levels and norms will ultimately govern practice, especially in light of changes in the social organization of medicine.
My dissertation research examines how innovative medical procedures are put into practice, specifically in the field of cardiac electrophysiology. It is based on practices at an elite academic hospital over a four year time period. My study begins with a team of resident physicians managing cardiology patients, and examines how they learn to process new knowledge on the wards. The study follows the residents through interdisciplinary discharge planning meetings; educational conferences among residents; and a cardiac electrophysiology laboratory. In addition to studying training of new physicians, the study analyzes data on physicians’ networks, their uses of the internet, and their relationships with students, colleagues and administrators.
Travelling with the residents and the senior cardiologists to annual meetings of their professional organizations and to industry-sponsored conferences, the study also discusses what impact these activities have on physician practice. To broaden the study, the practices of doctors in this one training hospital are compared with those of cardiac electrophysiologists in other centers within the US and abroad. The project and several other papers together seek to explain the relationship between medical knowledge and practice, and how medical work shifts and becomes stable.
My dissertation research examines how innovative medical procedures are put into practice, specifically in the field of cardiac electrophysiology. It is based on practices at an elite academic hospital over a four year time period. My study begins with a team of resident physicians managing cardiology patients, and examines how they learn to process new knowledge on the wards. The study follows the residents through interdisciplinary discharge planning meetings; educational conferences among residents; and a cardiac electrophysiology laboratory. In addition to studying training of new physicians, the study analyzes data on physicians’ networks, their uses of the internet, and their relationships with students, colleagues and administrators.
Travelling with the residents and the senior cardiologists to annual meetings of their professional organizations and to industry-sponsored conferences, the study also discusses what impact these activities have on physician practice. To broaden the study, the practices of doctors in this one training hospital are compared with those of cardiac electrophysiologists in other centers within the US and abroad. The project and several other papers together seek to explain the relationship between medical knowledge and practice, and how medical work shifts and becomes stable.
© 2008 Dan Menchik
