Medical authority, managerial power and political will: a Bourdieusian analysis of antibiotics in the hospital

Kirby, Emma, Broom, Alex, Gibson, Alexandra, Broom, Jennifer, Yarwood, Trent, and Post, Jeffrey (2018) Medical authority, managerial power and political will: a Bourdieusian analysis of antibiotics in the hospital. Health, 22 (5). pp. 500-518.

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Antibiotic resistance poses a significant global threat, yet clinically inappropriate antibiotic use within hospitals continues despite the implementation of abatement strategies. Antibiotic use and the viability of existing antibiotic options now sit precariously at the nexus of political will, institutional governance and clinical priorities ‘at the bedside’. Yet no study has hitherto explored the perspectives of managers, instead of focusing on clinicians. In this article, drawing on qualitative interviews with hospital managers, we explore accounts of responding to antimicrobial resistance, managing antibiotic governance and negotiating clinical and managerial priorities. We argue that the managers’ accounts articulate the problematic nexus of measurement and accountability, the downflow effects of political will, and core tensions within the hospital between moral, managerial and medical authority. We apply Bourdieu’s theory of practice to argue that an understanding of the logics of practice within the ‘hospital management classes’ will be critical in efforts to protect antibiotics for future generations.

Item ID: 58617
Item Type: Article (Research - C1)
ISSN: 1461-7196
Keywords: antibiotics, Australia, hospital, qualitative, sociology
Date Deposited: 13 Jun 2019 01:17
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3214 Pharmacology and pharmaceutical sciences > 321403 Clinical pharmacy and pharmacy practice @ 70%
42 HEALTH SCIENCES > 4203 Health services and systems > 420399 Health services and systems not elsewhere classified @ 30%
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