Showing papers by "Stefan Timmermans published in 2020"

The Engaged Patient: The Relevance of Patient-Physician Communication for Twenty-First-Century Health.

Abstract: The patient-doctor interaction has changed profoundly in the past decades. In reaction to paternalistic communication patterns, health policy makers have advocated for patient-centered care and shared decision-making. Although these models of medical communication remain still aspirational, patients have become more engaged in advocating for their own health in encounters with physicians. I argue that the engaged patient is a more accurate conceptualization of the changing role of the patient than patient consumerism, the empowered, or expert patient. I examine how the emergence of engaged patients influences the autonomy of health professionals, relates to the rise of the internet as an alternative source of medical information, centers the role of the patient-doctor interaction in public health epidemics, and contributes to health inequities.

Medical Authority under Siege: How Clinicians Transform Patient Resistance into Acceptance.

Abstract: Over the past decades, professional medical authority has been transformed due to internal and external pressures, including weakened institutional support and patient-centered care. Today's patients are more likely to resist treatment recommendations. We examine how patient resistance to treatment recommendations indexes the strength of contemporary professional authority. Using conversation analytic methods, we analyze 39 video recordings of patient-clinician encounters involving pediatric epilepsy patients in which parents resist recommended treatments. We identify three distinct grounds for parental resistance to treatments: preference-, fear-, and experience-based resistance. Clinicians meet these grounds with three corresponding persuasion strategies ranging from pressuring, to coaxing, to accommodating. Rather than giving parents what they want, physicians preserve their professional authority, adjusting responses based on whether the resistance threatens their prerogative to prescribe. While physicians are able to convert most resistance into acceptance, resistance has the potential to change the treatment recommendation and may lead to changed communication styles.

Technologies and Health Inequities

Abstract: Health technologies aim to improve individual and population health, but they may also exacerbate health disparities. Focusing on the specific design features of technologies, their availability, a...

Racist Encounters: A Pragmatist Semiotic Analysis of Interaction:

Abstract: Complementing discourse-analytic approaches, we develop C. S. Peirce’s semiotic theory to analyze how racism is enacted and countered in everyday interactions. We examine how the semiotic structure...

The cost of saving babies: How economists justify policies

Abstract: The relationship between economic ideas and public policy is a growing area of sociological inquiry. This paper examines a unique case of economic influence on policy: use of cost-effectiveness ana...

Loneliness in life and in death? Social and demographic patterns of unclaimed deaths.

Abstract: We examined family isolation, economic hardship, and long-distance migration as potential patterns of an extreme outcome of a lonely death: bodily remains that remain unclaimed and are left to the state. This paper combines a unique dataset-Los Angeles County's records of unclaimed deaths-with the Vital Statistics' Mortality data and the Annual Social and Economic Survey (ASEC) to examine 1) whose remains are more likely to become unclaimed after death and, 2) whether population-level differences and trends in family isolation, economic hardship, and long-distance migration explain the differences in the rates of unclaimed deaths. We employ multivariate Poisson models to estimate relative rates of unclaimed deaths by social and demographic characteristics. We find that increases in never married, divorced/separated, and living without family were positively associated with rates of unclaimed deaths. Unemployment among men and poverty among women was associated with higher unclaimed deaths. Long-distance migration was not associated with more unclaimed bodies.

Sequential Comparisons and the Comparative Imagination

Abstract: This chapter outlines three basic modes of comparison ethnographers wield: shadow comparisons to other cases that inform observations, internal comparisons among observations and other units of analysis within the case, and varieties of external comparison among different field sites. The authors then make two complementary arguments. First, the chapter widens ethnographers’ comparative imagination by arguing that ethnographers need to pay more careful attention to the interplay among different kinds of comparisons. And, second, the case is made that a preferred strategy for external comparison is sequential comparison, in which the ethnographer first abductively finds important puzzles in one field, and only then chooses a second field according to emerging theoretical themes.