Tensions within the public encounter: Balancing individual and population health risks

In this chapter we focus on one area of healthcare practice in which tensions arise - the balancing of risks of acute infection to individuals with the risks of increasing antimicrobial resistance (AMR) to the wider population. Using a theoretically informed survey of public-facing healthcare professionals, we uncover the tensions between their knowledge about infection and AMR, organizational interventions designed to address AMR and the relational dynamics of applying interventions to specific clinical settings. Healthcare professionals navigate these tensions by negotiating pathways for action that have enough coherence for them to live with it. This coherence emerges through their interactions with patients and colleagues. 'Seeking coherence' therefore is introduced as a new concept, better suited to account for the way decision-making occurs in the context of the ongoing and often irresolvable tensions between individual and population based health risks.