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The article presents a paper that explores ways in which general practitioners make sense of the changing political economy of this relationship. It explains that the interpersonal relationship between doctor and patient is fundamental to general medical practice. However, it is restructured by ideas about the patient as consumer, and as it increasingly constitutes the consultation as a point of interaction that may be intrinsically therapeutic. In particular, ways are explored in which consultation is the site of negotiated power relations between doctor and patient, and is the site of the doctor's negotiation of powerful discourses of professional and institutional identity. It develops some ideas about the relationship between doctors and patients in general practice. It focuses on the ways in which the professional rhetoric of general practice has come to be organized around a very specific view of the possibilities that arise from this relationship.

This paper focuses on two areas of innovation currently articulating the agenda of personalized medicine (PM): the discourse of empowerment in health-care reforms and the rise of molecular epigenomics. We align these two developments as discursive and technical resources, focusing on their nascent interplay in shaping alternative sociotechnical imaginaries of PM. Our work aims at inaugurating an intellectual programme on the distinct futures of policy- and identity-making that are being catalysed around epigenomic technoscience, as well as to provide an operational map of its potential synergies with pre-existing socio-political discourses of empowerment in PM. This roadmap advances our understanding of how the intersection of epigenomics with dominant policy discourses becomes a resource to shape roles and obligations of citizens, patients and health-care actors in the emergence of PM. [ABSTRACT FROM AUTHOR]

This paper draws on data from a small-scale ethnographic study of the delivery of maternity care to South Asian descent women in a hospital in Southern England during 1988. Stereotyped views of these women which related to their customs and culture as well as their typification as patients were commonly expressed by staff, particularly midwives. The paper examines the role of medical records and record making in stereotyping Asian women: the ways in which stereotyped views of women may affect the record making process; and how that process itself may reinforce and create stereotypes. The utility of records for `rate production' purposes is also discussed. The focus of the paper is the creation of a woman's maternity records which occurs in the antenatal clinic. The transformation of stigmatised views of a client into `facts' about a client is common among bureaucrats, in this setting health service staff. This process affects the client's future encounters with the bureaucracy. In medical settings records (i.e. the case notes) help to create, transmit and reify negative stereotypes of health service users. These stereotypes can affect the kind of care given to individual patients. [ABSTRACT FROM AUTHOR]

This paper examines the logic of evaluation of health care services, calling into question the possibility of assessing the extent to which medicine and health care systems are 'rational' or 'irrational'. The paper analyses and rejects claims to rationality made in discourses on evaluation and in particular economic evaluation, by recourse to Weber's distinction between formal and substantive rationalities. The rationality claimed by evaluation is a value-laden and therefore substantive rationality. Similarly, the claims of the rational actor model are seen to over-simplify the ways actors interact in the market. [ABSTRACT FROM AUTHOR]

This paper argues that two models of illness can be identified within Parsons's paradigm--a structural model focusing on illness as incapacity for rle performance and a psychodynamic model focusing on illness as motivated deviance. Medical sociology, it will be said, has overlooked the psychodynamic or deviance model while recognizing and criticizing the structural or incapacity model under the misplaced label of deviance. It will further be ventured that while some elements of these two models can easily be fitted into a conservative view of medical practice, other elements are more difficult to reconcile with conservatism. [ABSTRACT FROM AUTHOR]

In this paper we are concerned with the study of the changing balance of power in the health care services between professionalism, unionism and the state within the British National Health Service. Our approach is macro-sociological and historical. Ours is a structural analysis in which we explore the importance of class and sexual divisions in relation to the formation of occupational associations and to modes of occupational control: specifically, professionalism and unionism. [ABSTRACT FROM AUTHOR]