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Title: Breaking the ceremonial order: patients' and doctors' accounts of removal from a general practitioner's list
Authors: Stokes, Tim
Dixon-Woods, Mary
Williams, Simon
First Published: Jul-2006
Publisher: Blackwell Publishing
Citation: Sociology of Health and Illness, 2006, 28(5), pp.611-636
Abstract: The removal of patients from general practitioners’ (GPs) lists in the UK offers important sociological insights into what happens when the doctor-patient relationship ‘goes wrong’. An interactionist analysis shows how removers (doctors) and removed (patients) strategically invoke ‘rules of conduct’ to account for difficulties in the doctor-patient relationship and for GPs’ decisions to end their relationships with patients. In this paper we extend this analysis through recourse to Bourdieu’s theory of practice, by juxtaposing ‘paired’ accounts of the same removal event by both remover and removed. Our analysis demonstrates the unthinking or non-reflective nature of people’s understanding of the rules governing social interactions, but also demonstrates how apparent rule violations make the rules explicit and expose patterns of power distribution. We argue that removal of patients amounts to a strategic exercise of symbolic power by GPs, and that this is experienced as an overtly violent symbolic act by patients. A theoretical reconciliation of interactionist theories of the doctor-patient relationship with Bourdieu’s theory of practice is both possible and profitable, providing a micro-macro link in which issues of capital and power within the health (care) field are brought to the fore.
Type: Article
Description: This is the authors' final draft of a paper published as Sociology of Health and Illness, 2006, 28(5), pp.611-636.
Appears in Collections:Published Articles, Dept. of Health Sciences

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