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Occupational rituals in patient management.

C L Bosk

    The New England Journal of Medicine
    |July 10, 1980
    PubMed
    Summary

    Physicians use occupational rituals during rounds and conferences to manage diagnostic and treatment uncertainty. These social practices help doctors evaluate outcomes and address patient care challenges, though data processing may threaten them.

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    Area of Science:

    • Sociology of Medicine
    • Medical Education
    • Clinical Decision-Making

    Background:

    • Physicians employ social practices, viewed as occupational rituals, in diagnosis and management.
    • These rituals are integral to medical team activities like rounds and conferences.
    • They aid physicians in navigating uncertainty, making treatment choices, and assessing results.

    Framework:

    • Analysis frames physician practices as occupational rituals.
    • Focuses on rituals in diagnosis, treatment decisions, and outcome evaluation.
    • Highlights eight strategies physicians use to manage uncertainty.

    Implementation:

    • Rounds and conferences serve as key settings for these occupational rituals.
    • Physicians utilize strategies such as hedged assertions, probability reasoning, and consultations.
    • Clinical experience and scientific evidence inform treatment decisions within these rituals.

    Implications:

    • Rituals dramatize the seriousness of physician responsibilities and patient care.
    • Grand rounds and mortality/morbidity conferences ritualize success and failure evaluation.
    • Modern medicine's data processing capacity may challenge the existence of these physician rituals.

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