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医疗专业人员的代理与药物化:俄罗斯的医工关系。

Medical professionals' agency and pharmaceuticalization: Physician-industry relations in Russia.

机构信息

European University at St. Petersburg, The Russian Federation.

Siberian State Medical University, The Russian Federation.

出版信息

Health (London). 2024 Jan;28(1):108-125. doi: 10.1177/13634593221116508. Epub 2022 Aug 1.

Abstract

In the contemporary world pharmaceuticals have become a go-to answer to a growing number of questions. This process of pharmaceuticalization gives rise to a concern with the increasing influence of the pharmaceutical industry on physicians' decision-making. Critics suggest that companies' for-profit-interests might compromise the integrity of medical practice. This article employs qualitative research methodology to explore how Russian physicians deal with the industry's efforts to expand and shape the use of pharmaceuticals. By bridging perspectives of social studies of science and sociology of professions, we offer a contextualized account of physicians' daily practices and interpretations related to pharmaceuticalization. The findings question conventional assumptions of physician-industry relations and allow to delineate a new form of medical professionalism that emerges in the context of pharmaceuticalization and cannot be reduced to either "resisting" industry marketing activities or "giving in" to them and thus corrupting biomedical expertise. Instead, the ways in which physicians navigate abundant sources of knowledge and use industry resources to overcome constraints of their organizational environment attest to mundane forms of agency exercised by physicians in their relations with industry.

摘要

在当代世界,药品已成为解决越来越多问题的首选答案。这一药物化进程引发了人们对制药业对医生决策日益增长的影响的关注。批评人士认为,公司的盈利利益可能会损害医疗实践的完整性。本文采用定性研究方法,探讨俄罗斯医生如何应对制药业扩大和塑造药品使用的努力。通过弥合科学的社会研究和职业社会学的观点,我们提供了一个与药物化相关的医生日常实践和解释的背景化描述。研究结果对传统的医生与行业关系假设提出了质疑,并允许描绘出一种新的医学职业主义形式,这种形式出现在药物化的背景下,不能简单地归结为“抵制”行业营销活动或“屈服于”行业营销活动并因此腐蚀生物医学专业知识。相反,医生在利用丰富的知识来源并利用行业资源来克服其组织环境的限制方面的做法证明了医生在与行业的关系中所行使的平凡形式的代理。

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