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Gatekeepers in the healthcare sector: Knowledge and Bourdieu's concept of field
Collyer, Fran M. Willis, Karen F. Lewis, Sophie
Collyer, Fran M.
Willis, Karen F.
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.
Keywords
Australia, gatekeeper, healthcare, bourdieu, field, capital, knowledge, choice
Date
2017
Type
Journal article
Journal
Social Science & Medicine
Book
Volume
186
Issue
Page Range
96-103
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled