Paper short abstract:

The objective is to contribute new insights on the intra- and inter-professional responses to, and dynamics within, an emerging jurisdiction of the medical profession, related to not only individual patients’ health problems but also global health problems such as antimicrobial resistance (AMR).

Paper long abstract:

This paper examines how professional medical practices govern and control current prescription of antibiotics in Danish primary care and how notions of 'good doctoring' may be relevant for understanding the handling and care of patients. Focus is on changing jurisdictions (Abbott 2005), normative registers of health care practices and transformative capacities of diseases in clinical settings (Mol 2009; Mol and Law 2004). Drawing on qualitative in-depth interviews with general practitioners (GPs) and abductive analysis (Tavory & Timmermans 2014), we explore professional practices of 'prudent use' of antibiotics. It is examined how GPs maintain a professional etiquette to distance themselves from the potential controversial case management (Armstrong & Ogden 2006) and how they manage dilemmas in clinical practice if and when decisions about antibiotic prescriptions cannot be based on facts about molecular conditions. By four trajectories (daily care; guidelines and 'wait and see' prescriptions; non-medical factors; attitudes towards professional engagements with antibiotic usage) the theoretical view of the intertwined nature of social and technical dimensions is followed. It is argued that jurisdictions are not purely made up of 'social stuff' such as identities, issues of control and authority but also by the normative conflicts that unfold around how a disease and the actual treatment with antibiotics matters between professional occupations, patients, standards, codes, measurement and techniques. Intra- and inter-professional responses to, and dynamics within, an emerging jurisdiction of the medical profession are demonstrated in relation to not only individual patients' health problems but also global health problems such as antimicrobial resistance.