From Paris to Phnom Penh: Understanding the Transnational Movement of Medical Expertise in New Settings

• In Event: 50220 - Section on Organizations, Occupations, and Work Roundtables
  In Refereed Roundtable (60 minute): Table 19: Medical Work

Abstract

Nancy is a primary care physician from France, Peter is an orthopedic surgeon from Norway, and Dennis is an anesthesiologist from Austria. Despite having different nationalities, areas of medical expertise, and professional credentials, they, and many other healthcare professionals like them, travel transnationally from the Global North to the Global South to assist with the provision of healthcare services in nongovernmental organizations (NGOs). While working in these organizational settings, they not only confront unfamiliar patients and pathologies, but also must collaborate with local healthcare professionals who work in the NGOs as paid staff. This paper examines the transnational movement of professionals and expertise from the Global North to the Global South by asking, “How do transnational healthcare professionals, and the organizations in which they work, manage the application of medical expertise in new settings?” I answer this question through a comparative ethnography of three NGOs in Cambodia that provide healthcare services and rely on foreign volunteer healthcare professionals to assist with treating patients and training local staff.
I find that foreign volunteer healthcare professionals continuously engage in impression management to adapt their medical expertise to local contexts and successfully perform their roles as medical experts. How such impression management unfolds depends on several factors, including the type of medical expertise being imported and adapted, the extent of professionals’ socialization into their new organizational settings, and the presence of formal organizational structures that regulate professionals’ activities. By identifying and explaining these processes, my findings challenge portrayals in the extant literature of professionals as being similarly trained and credentialed and therefore interchangeably pluggable into rationalized organizations across national contexts. Instead, professionals and organizations jointly and continuously define, negotiate, and redefine their roles to make expertise “work” as it travels transnationally to new settings.

Author

• Derek Richardson, Indiana University-Bloomington