Market Interactions and Status Sacrifices: The Counterintuitive Spread of Robotic Technologies in Medical Practice

• In Event: 322 - Section on Medical Sociology Roundtable Session
  In Refereed Roundtable: Table 15. Healthcare Organizations

Abstract

Recent decades have witnessed large capital investments by hospitals in advanced technologies. This development has not always been supported by physicians themselves, although they often receive the blame. To understand how market actors overcome normative opposition in medicine, this paper asks how an expensive and unproven technology came to be valued by physicians in a field which, in theory, should have opposed its adoption. In the early 2000s, a robotic technology spread among doctors for whom manual dexterity – their “good hands” – underpins status judgments. These technologies substitute a joystick for the use of hands to guide a catheter. Because the skills for using the computer interface are completely different from those necessary to manually operate a catheter, the technology renders largely irrelevant traditional standards for status in the field. To account for this counterintuitive case of adoption, this study draws on interviews with physicians and salespersons, demographic data on cardiac electrophysiologists, a content analysis of the corpus of research articles on the technology, sociometric data on authorship of these articles and clinical guidelines, and cross-national data on national investments in health and technology. In contrast to a dominant perspective that would account for these changes in terms of interprofessional competition, this case shows that doctors’ valuation of new practices really happens because they work in a country whose political institutions reward hospitals’ efforts to increase revenues. By looking beyond the interests of medical professionals themselves, this study reveals previously unforeseen relationships between the market, national institutions, and professional change.

Author

• Daniel A. Menchik, Michigan State University