School of Social and Political Sciences - Research Publications

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Start date: 2000 × End date: 2009 × Type: Journal Article × Subject: Sociology × Author: Lewis, Jennifer ×

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Now showing 1 - 4 of 4
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    Being around and knowing the players: Networks of influence in health policy
    Lewis, JM (PERGAMON-ELSEVIER SCIENCE LTD, 2006-05-01)
    The accumulation and use of power is crucial to the health policy process. This paper examines the power of the medical profession in the health policy arena, by analysing which actors are perceived as influential, and how influence is structured in health policy. It combines an analysis of policy networks and social networks, to examine positional and personal influence in health policy in the state of Victoria, Australia. In the sub-graph of the influence network examined here, those most widely regarded as influential are academics, medically qualified and male. Positional actors (the top politician, political advisor and bureaucrat in health and the top nursing official) form part of a core group within this network structure. A second central group consists of medical influentials working in academia, research institutes and health-related NGOs. In this network locale overall, medical academics appear to combine positional and personal influence, and play significant intermediary roles across the network. While many claim that the medical profession has lost power in health policy and politics, this analysis yields few signs that the power of medicine to shape the health policy process has been greatly diminished in Victoria. Medical expertise is a potent embedded resource connecting actors through ties of association, making it difficult for actors with other resources and different knowledge to be considered influential. The network concepts and analytical techniques used here provide a novel means for uncovering different types of influence in health policy.
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    Changing professions - General Practitioners' perceptions of autonomy on the frontline
    Lewis, JM ; Marjoribanks, T ; Pirotta, M (SAGE PUBLICATIONS LTD, 2003-03-01)
    Professional autonomy is a much-used concept which has operated with scant empirical attention directed at understanding its meaning among practitioners. This study investigates how General Practitioners (GPs) understand their professional autonomy, and what they perceive to be the main threats to it. Four focus groups were attended by 25 GPs in Melbourne. We found that GPs aspire to an ‘ideal type’ of professional who has the freedom to determine what is best for patients, but they believe their autonomy is threatened by financial constraints, greater accountability requirements, and more demanding patients. These findings reveal how GPs understand autonomy in their practice, and indicate that their concerns may have little to do with the deprofessionalization and proletarianization theses. Micro-level studies of GPs in the workplace, combined with greater understandings of different aspects of professional autonomy, appear useful in understanding how GPs’ work and autonomy is changing.
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