Prestige hierarchies of diseases and specialities in a field perspective

Abstract

Previous research from Norway on the prestige ranking of medical specialities shows that physicians rank specialities as well as diseases according to social prestige. The aim of this study was to theoretically supplement the Goffman-inspired studies by use of a Bourdieuian field perspective. This study’s relevance is its contribution to a theoretical understanding of stability and change in regard to prestige rankings, as well as social and symbolic acceptance linked to a disease. The paper presents key concepts and offers precision on the theoretical development. Theoretically, the paper suggests that a number of subfields create a complex network that connects and stabilises the field (subfields of institutions, subfields of professions, subfields of diseases, subfields of technology, etc.). Each of them operates with relative autonomy within a broader medical field, and as such they constitute a structural homology. With reference to both Album and Bourdieu, the paper suggests that while a disease can achieve a higher prestige through its association with a new medical technology, its triumphs in the internal struggles with its rivals are limited, since it is still part of a complex network linked with logics from other subfields which regulate its rise and fall in the overall prestige hierarchy. Stability is built (in relations) within medical institutions, medical professions and diseases.