Ascribing emotion to reasonable use in accelerated cancer services

Abstract

A recurrent theme in medical sociology has been the juxtaposition of emotion with scientific rationality in the delivery of health care services. However, apart from addressing this juxtaposition very little is said about the complex intertwinement of "emotional" and "rational" practices which makes up professionals' own day-to-day work experiences - and how these experiences are influenced by present ways of organising health care. This paper aims to explore the ways that hospital doctors relate emotions to their understanding of professional medical work and how they respond to recent organisational changes within the field. Drawing upon a small series of semi-structured interviews (n = 14) with doctors from a public teaching hospital in Denmark, the paper adopts a constructivist framework to analyse personal biographies of health professionals' working lives. The doctors represented rich accounts of professional medical work, which includes an understanding of what a doctor should feel and how he/she should make him/herself emotionally available to others. However, the impetus for making this appearance was not left unaffected by recent new public management reforms and attempts to accelerate the delivery of services. The organisation of cancer services into a work system, which consists of a set of tasks broken down into narrow jobs, underestimates the emotional components of patient-doctor encounters. This makes the creation and maintenance of a genuine patient-doctor relationship difficult and the result is feelings of a failed encounter on behalf of the doctor. The paper suggests that recent rearrangements of cancer services complicate doctors' ability to incorporate emotion into a stream of medical care in a "rational" way. This is shown to challenge their professional ethos and the forms emotional engagement takes in medical practice.