Abstract
This article explores the professional project for an emergent subaltern specialist community of wound healing clinicians. Drawing on the literature on professions and boundary work, it examines how wound healing clinicians challenge the perception of their work as 'dirty' and seek its transformation into a specialism of 'woundology'. The article is based on an ethnography of a UK multidisciplinary team of doctors and nurses with an interest and expertise in wound healing, who work as clinical academics and provide wound care services in outpatient clinics. It demonstrates that wound healing clinicians vindicate their professional status by seeking to enthral the medical community in 'dirty wound care' as a focused clinical specialty of 'woundology'. Through training nurses to do medical wound care work, educating clinicians from other specialties about wounds and undertaking wound research, wound healing clinicians assert the professional boundaries of their specialism and its fit with mainstream medicine without embellishing the dirty aspects of their work.
Highlights
Wound healing is a novel medical area focused on the treatment of skin tears
Scientific advancements in wound healing have not been matched by a professional recognition of ‘woundology’ as a standardised evidence-driven medical specialisation focused on diagnosing and treating patients with wounds (Harding 2008)
As observed by Madden, ‘[m]ost of the care of people with chronic wounds in the UK is undertaken by nurses with involvement from a wide range of health and social care services and specialisms including tissue viability, surgery, dermatology, care of the elderly, podiatry, physiotherapy and occupational therapy’ (2012, p. 2047)
Summary
Wound healing is a novel medical area focused on the treatment of skin tears. Until the second half of the 20th century, the understanding of wound healing hinged largely on changing bandages. It asks: ‘how do clinicians with an interest and expertise in wound healing engaged in dirty work seek to vindicate their professional status in medicine?’ The article starts with a brief review of sociological literature depicting wound healing as dirty work It summarises seminal contributions on professionalisation and professional projects (Abbott 1988, Friedson 1970, Gieryn 1983, Halpern 1988, Larson 1977, Weisz 2006). They called for a pluralistic approach to understanding the establishment of new professional roles that recognised the concomitance of sources of authority from a process perspective In this regard, the concept of boundary work has become a useful heuristic. The germane point here is that the development of new professional roles is an ongoing process of boundary creation, preservation and contestation, which might offer a way of dealing with the problematic notion of professional jurisdiction in multidisciplinary fields
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