Adoption in the Shadow of the Profession: Medical Innovation Revisited

Medical Humanities aim to complement the efforts of healthcare professionals and here Organisational Studies play a pivotal role. This chapter illustrates that pivotal role by exploring how the internal dynamics of the medical community can contribute to differences in healthcare resource distribution and the consequent health disparities. We treat medicine as a system of profession, a sociological concept that distinguishes medicine from occupations without abstract knowledge. We present the results of a vignette-based survey where oncologists and haematologists recommend drug-based treatments based on six identical patient profiles and then answer questions about their professional networking and information gathering behaviours. Identical patient descriptions allow us to set aside dynamics outside the medical profession. To capture variation in the dynamics of the medical community, we sampled physicians in the UK and Mexico and set patient profiles to rare cancers. We find that, even in our controlled conditions, the recommended treatments are not binary but multiple and that casual professional discussions are unevenly associated with these multiple treatment choices. Our data suggest that cancer rareness exacerbates physicians' need for advice from the larger medical community. Lastly, we document similarities and differences in the professional behaviours of physicians in middle- and high-income countries.