4 The ‘lay/professional’ axis
As we said at the beginning of the last section, much of the impetus in earlier work on lay perspectives was to examine how far they deviated from the ‘true’ knowledge of experts. Now the emphasis has changed and there is a move to try to understand lay knowledge in order to inform expert knowledge, and in the process the distinction is increasingly being questioned. As Bury notes, the ‘opposition between the world of patients and doctors has been a major theme in medical sociology’ (1997, p. 20).
Activity 7: Worlds apart?
Listen to the audio clip, ‘The views of doctors’, where four doctors give their views on health. The first one Sir John Crofton, who is now retired but who used to work as a consultant chest physician at the Edinburgh Royal Infirmary. He has been very active in supporting community initiatives. He is optimistic that the rigid medical views on health held by his generation of doctors are less dominant among younger doctors. The next three doctors you hear represent more modern views. They are all currently working at the Birmingham Heartlands Hospital diabetes centre. First you hear Professor Tony Barnett, who is head of the diabetes centre. He is followed by Dr Sudhesh Kumar, who also works at Heartlands Hospital, and finally you hear Dr Philip Dyer, who is one of the specialist registrars at the diabetes centre.
Note down how far you think that Sudhesh Kumar, Tony Barnett and Philip Dyer are broadening their view of health as the first doctor, Sir John Crofton, suggests may be the case.
Transcript: The views of doctors
Now listen to the audio clip, ‘Two community workers’, where two health professionals who work in the community link their views on health to policy and practice. First you hear Jane Jones, who is a community health worker and founder member of the Pliton Community Heatlh Project, and second you hear Dr Jill Meara who is a consultant in community medecine for Northampton Health Authority. Jill helped to establish the Right Angle Health Project which is concerned with health and lifestyles in rural and urban areas of Northampton.
Note down the implications this has for their practice.
Transcript: Two community workers
Sudhesh Kumar, Tony Barnett and Phillip Dyer clearly see health as more than the absence of disease or a set of signs and symptoms, and they all talk about the importance of the social and economic background of their patients. So there is certainly a change from the old-fashioned way that physicians used to deal with a body in the bed, or an organ in a bed, as Sir John Crofton puts it. Jane Jones and Jill Meara go much further in applying their broad view of health and question the medical dominance of health. They try to address the issue of powerlessness and find ways to give people in the community a much greater say in the issues that concern them.