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Doctors' labour and medicines are special necessities for human survival and evolution. Since China launched the healthcare reform, the theoretical circles' discussions have not yet clarified the respective special properties of doctors' labour and medicines as goods and the internal relations between doctors' labour and medicines at the level of the theoretical basis.

Health is a prerequisite for people's all-round development, a precondition for economic and social development and the people's common aspiration. The all-round moderately prosperous society could not be achieved without people's all-round health.

The authors believe the socialist relation between doctors' labour and medicines with Chinese characteristics should be one that is people-oriented, and the corporatization of hospitals or the capitalization of doctors' labour should be avoided.

In this paper, the authors explore the particularity of doctors' labour, particularity of medicine production, circulation, consumption and the internal relations between doctors' labour and medicines by using the analytical approach of Marxist political economy while considering the special roles of doctor's labour and medicines in the reproduction of labour power and put forward the theoretical basis for the segregation of doctor's labour and medicines.

To explore theoretically the reasons for the modest uptake of clinical governance practices by taking the literature on the origin of tensions between doctors and managers as the starting‐point.

The approaches of doctors and managers to the division and coordination of medical work are analysed theoretically from a twofold perspective that combines insights from sociologists' theories on “professionalism” and administrative scientists' theories on “management science”.

The combined perspective theoretically explains the problems between doctors and managers that frustrate the uptake of clinical governance practices. By inference from this theoretical analysis, a twofold agenda for a constructive dialogue is proposed. Doctors and managers must develop a shared vision of the division and coordination of medical work as well as discussing the values, norms and goals underlying patient care. It is questionable, however, whether this agenda is currently adequately addressed.

This paper provides a theoretical underpinning for the dialogue between doctors and managers. It may be enlightening for all doctors and managers working in the field.

Twin to Twin Transfusion Syndrome (TTTS) is a well understood, yet under-recognized, placental disease affecting any given pregnancy at a rate of 1 in 1,000. There is no clustering of TTTS; instead the threat remains pathologically distinctive due to its pervasiveness. However, while incidence rates are random, survival rates are not. Despite compliant acceptance of “routine prenatal care,” sadly, there are many women who for currently unknown reasons are not receiving the advanced prenatal care needed to appropriately screen for, diagnosis and treat TTTS. And these women are paying the ultimate price for such obstetrical oversight.

This study hypothesizes that differential care being given by primary obstetricians of TTTS patients is resulting in experienced inequalities. Utilizing social reproduction theory, and through ethnographic and quantitative analyses of primary data, this study seeks to divulge the complex social processes taking place (or failing to take place) within the world of American obstetrics, and begin to understand how they are affecting TTTS mortality and morbidity rates.

Findings illuminate a profound imbalance of power and influence amongst the following entities: American Congress of Obstetricians and Gynecologists and Society of Maternal Fetal Medicine; obstetrical training and practice; and levels of patient awareness and advocacy.

This study argues that the current social relations being reproduced by these entities are perpetuating a climate that allows for disregard of proper TTTS management. Specifically, this study theoretically explores what social relations and subsequent (in)actions are being reproduced prior to TTTS diagnoses, and applies the effects of those observations.

Changing market conditions, new modes of labour and decreasing legitimisation of experts, as well as an increasing ratio of women, pose new challenges to the professions. These ongoing dynamics are especially visible in the health care system – a traditional professional field with strongly formalised rules governing entrance, initiation and career paths. In addition, this field is highly segregated according to sexes. How do the bove‐mentioned processes of change present themselves and what economic, social or structural factors cause them? What role does gender play within these processes? What potential lies in the re‐structuring processes of health care systems as far as a gender equal architecture and design of professions is concerned? These and other questions are addressed in this collection of papers. For the main part they grew out of a thematic focus event organised and coordinated by the editors for the 5th Conference of the European Sociological Association (ESA) Research Network Sociology of Professions that was held in 2001 in Helsinki. Inspired by the richness of the research results on professions and gender in health care systems in various European countries and new horizons which opened up from the comparative perspective in different countries, professions, and theoretical approaches, and finally motivated by very constructive ensuing discussions, we decided to continue the discussion with a publication.

Frequently women are attended by someone other than their chosen doctor during labor and delivery, that is, an “on-call” doctor. This chapter draws from interviews with 19 women who gave birth in a Mid-Atlantic state during late 1995 and early 1996. Of these women, 13 received care from an on-call doctor. Using existing social–psychological perspectives, the authors analyze situations in which an on-call doctor was present, and how this provider influenced women's birth experiences as well as satisfaction with those experiences. In general, women do not expect or desire on-call doctors’ presence. As a result, they may rely on obstetric nurses, rather than these unfamiliar doctors, when they need information or support.

With an aim to investigate the recent state of the feminist clinics and their negotiation of medical authority in a time of increased technoscientific biomedicalization, and capitalistic health-care system, I conducted a study of two feminist health centers in the Northeast of the United States in 2001–2002. In this chapter, I discuss how the two centers (a nonprofit collective and a for-profit center with a more hierarchical structure) negotiated medical authority in organizational terms as impacted by the larger context of medicine and its interaction with the state, capitalist health-care system, and antiabortion forces. The chapter concludes with a discussion of demedicalization as a multilevel process and implications for feminist care (service delivery) and U.S. Women's Health Movement.

The emotionally taxing nature of health‐care work has been increasingly recognized. In parallel, the field of work and family has been searching for more specific antecedents of both work interference with family (WFI) and family interference with work (FWI). The current study aims to examine the relationship between surface acting and hiding negative emotions with WFI and FWI among Greek health‐care professionals.

The research is a cross‐sectional study of 180 Greek doctors and 84 nurses using self‐report measures.

Results indicated that, for doctors, surface acting at work was positively related to WFI and, for nurses, surface acting at home was positively related to FWI.

The respondents were sampled on a convenience basis and the non‐random procedure may have introduced unmeasured selection effects. The present study is cross‐sectional and thus the postulated relationships cannot be interpreted causally.

Emotional management training and opportunities for emotional decompression for Greek health‐care professionals should be explored. In terms of medical education, the need to train students to understand and cope with emotional demands is an important first step. This research highlights the need for communication‐skills training courses facilitating emotional awareness and emotional management.

These findings position emotional labour as an important antecedent of both WFI and FWI.

This paper reflects on the output of four ethnographic research projects examining the implementation of the Dutch Inspection for Work and Income. These four reports were to open up the “black box” concerning the everyday negotiations involved in implementation and particularly focused on the actual contribution of various participants to this process.

The paper presents an analysis, a political re‐reading of four reports, examining the underpinning questions and assumptions behind the work of the ethnographic research.

The paper raises questions about the role of ethnographic researchers. It analyses, for instance, the ways in which researchers framed the “objects of concern” they investigated on behalf of the inspection and the political effects of their fieldwork choices, including the selection of their respondents and the ways they dealt with them throughout the research.

In the context of evaluative reports that are to be made public as part of a political process, the inadequate or unequal representation of particular actors has wider political consequences. Researchers need to explicitly engage with these issues raised in their reflections on the process and their findings.

Aim: To assess the potential for improved clinical effectiveness through the use of research‐based evidence in obstetric care. Design: A questionnaire survey to obtain evidence about (i) the usage of reviews of controlled perinatal trials, and (ii) the attitudes of professionals towards the reviews and their practice, relating to 27 areas of clinical care addressed by the reviews. Subjects and setting: All doctors and midwives working in two teaching hospital maternity units (Units X and Y). Main outcome measures: The use of the reviews. For each of the 27 areas of clinical care, (i) whether a majority of professionals were in agreement with research‐based evidence, and (ii) how perceived current practice compared with research‐based evidence. Results: For most areas of clinical care (21/27 in unit X, 20/27 in unit Y) a majority of professionals agreed with the research‐based evidence. However, for a large proportion of these areas (16/21 in unit X, 12/20 in unit Y), practice appeared to be inconsistent with research‐based evidence. Conclusion: There is a considerable opportunity to improve clinical effectiveness, as in many of the areas of care examined professionals agree with research‐based evidence, but clinical practice appears to be inconsistent. The approach used in this study could be used to help develop practices for promoting clinical effectiveness.

The aim of this paper is to investigate the factors that influence promotions of medical staff from registrar to consultant in the Scottish NHS.

The paper addresses the question of what determines the incidence of promotion, concentrating on the impact of experience, effort and the choice of specialty in promotion outcomes. A unique panel data set is used that contains individual level information on all NHS hospital doctors in Scotland from 1991 to 2000. Probabilities of promotion are decomposed by specialty into the part attributable to the mean characteristics of the doctors in each specialty and the effect of belonging to a specialty itself.

The paper estimates a panel model of promotion and identifies specialty effects on promotion. Effort in the two years before promotion is shown to have an influence on promotion probabilities. Specialties are found to exhibit considerable differences in their rate of promotion over and above the differences explained by the characteristics of the doctors in them.

The paper examines the promotion of medical staff from registrar to consultant in the Scottish NHS during the 1990s. The paper concentrates on the impact of experience, effort and medical specialty on the probability of promotion.