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Habilitation à diriger des recherches

Vers des médecins organisateurs ? Initiatives organisationnelles, professions et pouvoir à l’interface de la pratique et de la recherche cliniques

Abstract : Based on materials collected over the past 15 years, this work focuses on a series of initiatives aimed at changing the practices and work organization of physicians in oncology, notably towards their greater involvement in research activities. Clinicians play a central role in these initiatives. These are middle-range modalities of integration between, at one extreme, the informal (traditional) professional organization and, at the other extreme, more formally defined and potentially more conflictual modalities, such as mergers or the strengthening of the managerial line. They can be analyzed as cautious - political - attempts to regulate increasingly complex activities within biomedicine, due to the number of different professions and skills potentially required. These initiatives are part of major change processes in health systems in general and on oncology field in particular, such as the push for coordination as a principle of public policies. However, in comparison with many existing theses, the study of these initiatives shows that these changes are not limited to the progression of managerial logics alone; medical research thus appears to be another powerful organisational factor. Like previous researches, it is shown that, in our contemporary societies, organization is expanding. But organizational society does not only extend in the sense of formal integration and a reinforcement of verticality; this research tends to show that it also extends in a more horizontal way and through less formalized processes. Finally, the study of these organizational initiatives shows that the identification of major institutional logics or general political operators is not sufficient to understand change dynamics in health systems; it is necessary to look at the way in which the mesological order, based on power relations between actors, mediates these macro-social forces.
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Habilitation à diriger des recherches
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Submitted on : Tuesday, March 29, 2022 - 4:08:29 PM
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Patrick Castel. Vers des médecins organisateurs ? Initiatives organisationnelles, professions et pouvoir à l’interface de la pratique et de la recherche cliniques. Sociologie. Université de Versailles Saint-Quentin-en-Yvelines, 2020. ⟨tel-03623314⟩



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