Travelling knowledge: the glocalization of medical professional knowledge and practice
Duration: June 2018 through January 2021
The project contributes to globalization studies through an empirically grounded theory of the ways in which professional knowledge works across borders. Professions are seen as a third and globalizing form of regulation besides market and state since they govern themselves heterarchically through peer recognition of professional knowledge.
The project uses professional knowledge and practice of physicians as a test case for globalization studies. Medical knowledge is likely to universalize since it is based on natural science evidence; many doctors are migrants and/or practice abroad, and the field has become more standardized. However, the national organization of health care and medical education, as well as the nature of the doctor-patient relationship, could also result in a boundedness of medical knowledge. We see medical knowledge both as universalizing through standard diffusion and as a situated response to socio-material problems, or, as Robertson (1992) suggests, as glocalized. Thus, we attempt to overcome clear-cut dichotomies between global and local, between universal and particular in the study of globalization. The empirical study will focus on the treatment of a single medical condition, chronic systolic heart failure (CSHF), in order to connect a macrosocial analysis of standard setting through transnational professional associations with the microsocial observation of situated professional knowledge and practice in treating this disease. By studying the global actor constellation that disseminates treatment standards for CSHF we will trace processes of standard setting and diffusion that go beyond national cardiologic associations. By observing the treatment of simulated patients in medical pedagogical settings the project analyzes the ways in which standards inform tacit knowledge in practice. Observations at four university hospitals (Essen, Beijing, Maastricht/NL, Hacettepe/TR) maximize social and geographic distance.
The project delivers foundational research in the sociology of globalization based on a multi-method comparative study. On the basis of multiple embedded comparisons the project will show whether and to what extent knowledge universalizes through standard diffusion, shared contention and mobility. It also develops a more nuanced understanding of the ways in which professional knowledge remains particular and/or locally bound due to e.g. divergent standards, particular national health systems, epistemic and language communities, and position in migratory networks. Applied results of the project will aid the internationalization of medical education and improve cooperation between physicians in internationalized settings.