Mediating Certainty and Uncertainty in Medical Decision-Making: Feedback Loops and Projected Outcomes
How does knowledge inform practice in medical decision-making? This paper argues that the pace of task-driven feedback loops influences when physicians enact authoritative personas and deploy scientific resources. Drawing on fieldwork with a team of residents participating in a variety of hospital scenarios, it also reflects four years of interviews and first-hand observations of other teams. Temporal factors organize trainees’ decisions because higher education has prepared them more effectively for “test-like” scenarios rather than those involving greater interpretation and contingence. However, since it is not medically justifiable to defend these decisions according to the demands of their time horizons, trainees deploy research findings to align themselves with the (more defensible) ideology of Bayesian decision-making. That they instrumentally deploy these findings to reach everyday goals suggests, then, applying scientific findings is an interpretive act organized by projected outcomes – the opposite of the routinized rule-following often associated with evidence-based medicine and implied by the common label of “cookbook medicine.”
Join us for Dr. Menchik’s lecture on Wednesday, March 13, 2013 from noon till 1 pm in person or online:
In person: The lecture will take place in East Fee Hall on MSU’s East Lansing campus, in the Patenge Room (C102). Directions. Feel free to bring your lunch! Beverages and light snacks will be provided.
Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!
Daniel A. Menchik recently joined MSU as Assistant Professor in the Department of Sociology and Lyman Briggs College. His research interests lie in the sociology of medicine, the sociology of knowledge, the sociology of science, and social theory. A current empirical interest is how medical practices are influenced by others at the bedside, but also bureaucratic policies, industry actors, and elite physicians on guidelines panels. A methodological interest is finding new ways to identify the feedback loops between these levels using field-based interviews and observations. Menchik took his BA at University of Wisconsin—Madison, his MPhil from the University of Cambridge, and his PhD from the University of Chicago.
Event flyer: MAR BB_Webinar ad 12_13