Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients
The stability of physicians’ authority over patients despite decades of changes in medicine conflicts with newer institutionalist accounts of professionals as change agents rather than instruments of reproduction. We analyzed whether the cultural scripts that twenty-one residents used to justify the...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
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| Series: | Future Internet |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1999-5903/14/12/367 |
| _version_ | 1797458176386269184 |
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| author | Celeste Campos-Castillo Noelle Chesley Onur Asan |
| author_facet | Celeste Campos-Castillo Noelle Chesley Onur Asan |
| author_sort | Celeste Campos-Castillo |
| collection | DOAJ |
| description | The stability of physicians’ authority over patients despite decades of changes in medicine conflicts with newer institutionalist accounts of professionals as change agents rather than instruments of reproduction. We analyzed whether the cultural scripts that twenty-one residents used to justify their approach to a new change, the electronic health record (EHR), signaled a leveling of the patient-physician hierarchy. Residents are intriguing because their position makes them open to change. Indeed, residents justified using the EHR in ways that level the patient-physician hierarchy, but also offered rationales that sustain it. For the latter, residents described using the EHR to substantiate their expertise, situate themselves as brokers between patients and the technology, and preserve the autonomy of clinicians. Our findings highlight how professionals with little direct experience before a change can selectively apply incumbent scripts to sustain extant structures, while informing newer institutionalist accounts of professionals and the design of EHR systems. |
| first_indexed | 2024-03-09T16:34:17Z |
| format | Article |
| id | doaj.art-6748b2d71f2f418dbb16f772fe02ab33 |
| institution | Directory Open Access Journal |
| issn | 1999-5903 |
| language | English |
| last_indexed | 2024-03-09T16:34:17Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Future Internet |
| spelling | doaj.art-6748b2d71f2f418dbb16f772fe02ab332023-11-24T14:58:37ZengMDPI AGFuture Internet1999-59032022-12-01141236710.3390/fi14120367Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with PatientsCeleste Campos-Castillo0Noelle Chesley1Onur Asan2Department of Sociology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USADepartment of Sociology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USAStevens Institute, School of Systems and Enterprises, Hoboken, NJ 07030, USAThe stability of physicians’ authority over patients despite decades of changes in medicine conflicts with newer institutionalist accounts of professionals as change agents rather than instruments of reproduction. We analyzed whether the cultural scripts that twenty-one residents used to justify their approach to a new change, the electronic health record (EHR), signaled a leveling of the patient-physician hierarchy. Residents are intriguing because their position makes them open to change. Indeed, residents justified using the EHR in ways that level the patient-physician hierarchy, but also offered rationales that sustain it. For the latter, residents described using the EHR to substantiate their expertise, situate themselves as brokers between patients and the technology, and preserve the autonomy of clinicians. Our findings highlight how professionals with little direct experience before a change can selectively apply incumbent scripts to sustain extant structures, while informing newer institutionalist accounts of professionals and the design of EHR systems.https://www.mdpi.com/1999-5903/14/12/367agencyscreen sharingprofessional autonomyneo-institutionalismsociotechnical systems |
| spellingShingle | Celeste Campos-Castillo Noelle Chesley Onur Asan Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients Future Internet agency screen sharing professional autonomy neo-institutionalism sociotechnical systems |
| title | Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients |
| title_full | Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients |
| title_fullStr | Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients |
| title_full_unstemmed | Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients |
| title_short | Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients |
| title_sort | professionals as change agents or instruments of reproduction medical residents reasoning for not sharing the electronic health record screen with patients |
| topic | agency screen sharing professional autonomy neo-institutionalism sociotechnical systems |
| url | https://www.mdpi.com/1999-5903/14/12/367 |
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