Paper short abstract:

Based on semi-structured interviews, this paper critically examines the use of senses in diagnostic work, and problematizes new modes of healthcare such as telemedicine that compromise sensory judgments.

Paper long abstract:

The physical exam is the cornerstone of the medical encounter, yet this aspect of medical practice is being reconfigured in response to shifts in medical regulation and governance, developments in diagnostic testing, digital health technologies for self-monitoring and self-care, new modes of health care such as telemedicine and the techno-utopian discourses that surround them. Critical sociological scholarship highlights that in focusing on explicit medical knowledge and disembodied data we take for granted aspects of healthcare work, such as the ways in which health and illness is sensed. Sensing has always been a part of the skilled work of medical practice, to the extent that the mediated hearing of auscultation contributed to the establishment of medicine as a profession. However, recent research has captured practices such as dual use of the senses and tests. In telemedicine, sensory work is delegated, often to the patient, because this healthcare environment does not facilitate sensing directly. Based on semi-structured interviews, this paper examines the diverse ways doctors rely on their senses in diagnostic work, as well as the translations and transferences inherent in this sensing (sensing via a patient's sense, sensing via technology). It also problematizes new modes of healthcare such as telemedicine that compromise sensory judgments, and the extent to which they can transform health and care. I argue that the sensory work of diagnosis is vital, but it is left out of mainstream conversations about 'good' medicine and healthcare futures.