Gatekeepers in the healthcare sector: Knowledge and Bourdieu's concept of field

Journal article

Collyer, Fran M., Willis, Karen F. and Lewis, Sophie. (2017). Gatekeepers in the healthcare sector: Knowledge and Bourdieu's concept of field. Social Science & Medicine. 186, pp. 96 - 103. https://doi.org/10.1016/j.socscimed.2017.06.004
AuthorsCollyer, Fran M., Willis, Karen F. and Lewis, Sophie
Abstract

Choice is an imperative for patients in the Australian healthcare system. The complexity of this healthcare ‘maze’, however, means that successfully navigating and making choices depends not only on the decisions of patients, but also other key players in the healthcare sector. Utilising Bourdieu's concepts of capital, habitus and field, we analyse the role of gatekeepers (i.e., those who control access to resources, services and knowledge) in shaping patients' experiences of healthcare, and producing opportunities to enable or constrain their choices. Indepth interviews were conducted with 41 gatekeepers (GPs, specialists, nurses, hospital administrators and policymakers), exploring how they acquire and use knowledge within the healthcare system. Our findings reveal a hierarchy of knowledges and power within the healthcare field which determines the forms of knowledge that are legitimate and can operate as capital within this complex and dynamic arena. As a consequence, forms of knowledge which can operate as capital, are unequally distributed and strategically controlled, ensuring democratic 'reform' remains difficult and 'choices' limited to those beneficial to private medicine.

KeywordsAustralia; gatekeeper; healthcare; bourdieu; field; capital; knowledge; choice
Year2017
JournalSocial Science & Medicine
Journal citation186, pp. 96 - 103
PublisherElsevier
ISSN0277-9536
Digital Object Identifier (DOI)https://doi.org/10.1016/j.socscimed.2017.06.004
Scopus EID2-s2.0-85020249031
Page range96 - 103
Publisher's version
File Access Level
Controlled
Grant IDARC/DP130103876
Place of publicationUnited Kingdom
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