Professional autonomy and surveillance: the case of public reporting in cardiac surgery

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Professional autonomy and surveillance : the case of public reporting in cardiac surgery. / Exworthy, Mark; Gabe, Jonathan; Jones, Ian Rees; Smith, Glenn.

In: Sociology of Health and Illness, Vol. 41, No. 6, 07.2019, p. 1040-1055.

Research output: Contribution to journalArticlepeer-review

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Exworthy, Mark ; Gabe, Jonathan ; Jones, Ian Rees ; Smith, Glenn. / Professional autonomy and surveillance : the case of public reporting in cardiac surgery. In: Sociology of Health and Illness. 2019 ; Vol. 41, No. 6. pp. 1040-1055.

Bibtex

@article{11159c530acf44d6ab290296521492eb,
title = "Professional autonomy and surveillance: the case of public reporting in cardiac surgery",
abstract = "Professional autonomy has come under greater scrutiny due to managerialism, consumerism, information and communication technologies (ICT), and the changing composition of professions themselves. This scrutiny is often portrayed as a tension between professional and managerial logics. Recently, medical autonomy has increasingly been shaped in terms of transparency, where publication of clinical performance (via ICT) might be a more pervasive form of surveillance. Such transparency may have the potential for a more explicit managerial logic but is contested by clinicians. This paper applies notions of surveillance to public reporting of cardiac surgery, involving the online publication of mortality rates of named surgeons. It draws on qualitative data from a casestudy of cardiac surgeons in one hospital, incorporating interviews with health care managers and national policymakers in England. We examine how managerial logics are mediated by professional autonomy, generating patterns of enrolment, resistance and reactivity to public reporting. The managerial {\textquoteleft}gaze{\textquoteright} of public reporting is becoming widespread but the surgical specialty is accommodating it, leading to a re-assertion of knowledge, based on professional definitions. The paper assesses whether this form of surveillance is challenging to or being assimilated by the medical profession, thereby recasting the profession itself ",
keywords = "autonomy, medical profession, public reporting, surgeons, surveillance",
author = "Mark Exworthy and Jonathan Gabe and Jones, {Ian Rees} and Glenn Smith",
note = "{\textcopyright} 2019 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.",
year = "2019",
month = jul,
doi = "10.1111/1467-9566.12883",
language = "English",
volume = "41",
pages = "1040--1055",
journal = "Sociology of Health and Illness",
issn = "0141-9889",
publisher = "Wiley Online Library",
number = "6",

}

RIS

TY - JOUR

T1 - Professional autonomy and surveillance

T2 - the case of public reporting in cardiac surgery

AU - Exworthy, Mark

AU - Gabe, Jonathan

AU - Jones, Ian Rees

AU - Smith, Glenn

N1 - © 2019 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

PY - 2019/7

Y1 - 2019/7

N2 - Professional autonomy has come under greater scrutiny due to managerialism, consumerism, information and communication technologies (ICT), and the changing composition of professions themselves. This scrutiny is often portrayed as a tension between professional and managerial logics. Recently, medical autonomy has increasingly been shaped in terms of transparency, where publication of clinical performance (via ICT) might be a more pervasive form of surveillance. Such transparency may have the potential for a more explicit managerial logic but is contested by clinicians. This paper applies notions of surveillance to public reporting of cardiac surgery, involving the online publication of mortality rates of named surgeons. It draws on qualitative data from a casestudy of cardiac surgeons in one hospital, incorporating interviews with health care managers and national policymakers in England. We examine how managerial logics are mediated by professional autonomy, generating patterns of enrolment, resistance and reactivity to public reporting. The managerial ‘gaze’ of public reporting is becoming widespread but the surgical specialty is accommodating it, leading to a re-assertion of knowledge, based on professional definitions. The paper assesses whether this form of surveillance is challenging to or being assimilated by the medical profession, thereby recasting the profession itself

AB - Professional autonomy has come under greater scrutiny due to managerialism, consumerism, information and communication technologies (ICT), and the changing composition of professions themselves. This scrutiny is often portrayed as a tension between professional and managerial logics. Recently, medical autonomy has increasingly been shaped in terms of transparency, where publication of clinical performance (via ICT) might be a more pervasive form of surveillance. Such transparency may have the potential for a more explicit managerial logic but is contested by clinicians. This paper applies notions of surveillance to public reporting of cardiac surgery, involving the online publication of mortality rates of named surgeons. It draws on qualitative data from a casestudy of cardiac surgeons in one hospital, incorporating interviews with health care managers and national policymakers in England. We examine how managerial logics are mediated by professional autonomy, generating patterns of enrolment, resistance and reactivity to public reporting. The managerial ‘gaze’ of public reporting is becoming widespread but the surgical specialty is accommodating it, leading to a re-assertion of knowledge, based on professional definitions. The paper assesses whether this form of surveillance is challenging to or being assimilated by the medical profession, thereby recasting the profession itself

KW - autonomy

KW - medical profession

KW - public reporting

KW - surgeons

KW - surveillance

UR - http://www.scopus.com/inward/record.url?scp=85062971653&partnerID=8YFLogxK

U2 - 10.1111/1467-9566.12883

DO - 10.1111/1467-9566.12883

M3 - Article

C2 - 30874329

VL - 41

SP - 1040

EP - 1055

JO - Sociology of Health and Illness

JF - Sociology of Health and Illness

SN - 0141-9889

IS - 6

ER -