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Making information ‘relevant’: General Practitioner judgments and the production of patient involvement

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  • Clinch, Megan
  • Benson, John

Abstract

Sociological work that has engaged with the issue of patient involvement in health care suggests it needs to be recognised that decision-making is not simply an individual cognitive act contained in a single consultation, but a process that is distributed across multiple encounters in relation to a range of agents and non-human actors. Drawing on such conceptualisations of decision-making, and based on semi-structured interviews with 24 General Practitioners (GPs) in the United Kingdom about the prescription of statins for the primary prevention of cardiovascular disease, this paper explores the preemptive work that GPs perform when attempting to achieve patient involvement in healthcare decisions. The paper identifies a set of repertoires through which they evaluate and coordinate often contradictory forms of knowledge, transforming them into information that they think is relevant to patients, and which will potentially facilitate meaningful involvement in healthcare decisions. The study concludes by suggesting that such fluid and context sensitive practices are a necessary strategy for navigating complex health environments, which can be justified and underpinned by a relational model of autonomy. However, work needs to be done to explore how such judgments can be calibrated to mesh with the decision-making preferences of patients and what new approaches and standards for practice this would require.

Suggested Citation

  • Clinch, Megan & Benson, John, 2013. "Making information ‘relevant’: General Practitioner judgments and the production of patient involvement," Social Science & Medicine, Elsevier, vol. 96(C), pages 104-111.
    • Handle: RePEc:eee:socmed:v:96:y:2013:i:c:p:104-111
    DOI: 10.1016/j.socscimed.2013.07.034
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    References listed on IDEAS

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    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1999. "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science & Medicine, Elsevier, vol. 49(5), pages 651-661, September.
    2. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    3. Moreira, Tiago, 2005. "Diversity in clinical guidelines: the role of repertoires of evaluation," Social Science & Medicine, Elsevier, vol. 60(9), pages 1975-1985, May.
    4. Wirtz, Veronika & Cribb, Alan & Barber, Nick, 2006. "Patient-doctor decision-making about treatment within the consultation--A critical analysis of models," Social Science & Medicine, Elsevier, vol. 62(1), pages 116-124, January.
    5. Armstrong, David, 2002. "Clinical autonomy, individual and collective: the problem of changing doctors' behaviour," Social Science & Medicine, Elsevier, vol. 55(10), pages 1771-1777, November.
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    Cited by:

    1. Hardman, Doug & Geraghty, Adam W.A. & Lown, Mark & Bishop, Felicity L., 2020. "Subjunctive medicine: Enacting efficacy in general practice," Social Science & Medicine, Elsevier, vol. 245(C).

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