Assembling Homo Qualitus: Medical Professionalism in the Age of Quality

Discourse of quality has increasingly moved or multiplied from professional medical enclosures into public policies and reforms of healthcare systems since the mid-1990s. This paper offers an approach to the study of medical work that accounts for the significance of this movement. More specifically, it documents the relations between the discourse of quality and an assemblage of diverse elements (doctrines, devices and affects), and the construction of a new idealized image of the healthcare worker, homo qualitus, in the UK National Health Service (NHS). This worker is shown to be surrounded and equipped to speak a particular kind of quantitative, systemic and patient-centred language of quality, to engage in continual experimentation and tests of change, and to become an enthusiastic champion of the quality improvement agenda. Thus, it is a healthcare worker distinguished in relation not to tasks, jurisdictions, or classical professional skills, but to her individual characteristics of enthusiasm, engagement, and entrepreneurialism. These characteristics challenge, recombine, and reconstitute the distinctions – such as the classic professional- managerial analytical grid – upon which studies of medical work have historically relied.