Occupational Divisions of Labor and Their Technology Politics: The Case of Surgical Scopes and Gastrointestinal Medicine

Abstract

Through a case analysis of how medicine's intra-occupational division of labor responded to thedevelopment ofgastrointestinal endoscopy, this article sheds lighton how occupational divisions of labor respond to technological innovation. The article proposes that innovations are introduced into such structures in ways consistent with thecultural scripts thatregulate relations andworkflows between occupations' functional segments. However, these scripts may not be able to regulate effectively subsequent developments, and structural divisions may produce intra-occupational conflict and struggle over marketturf A "Trojan horse" metaphor is used to illustrate this process. The analysis developed here poses questions about thecurrent tendency toextol thevirtues ofoccupational divisions of labor, forsuch structures maylack effective mechanisms for regulating the unintended outcomes of technological change.

Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce

“…On the macro-level, there is a considerable literature considering this kind of work in action, exploring the role of, inter alia, professional bodies in defending existing epistemic and jurisdictional boundaries (Coburn, 1993;Evans, 2003;Zetka, 2001;Stevens, Diederiks, Grit & Horst, 2007;Mizrachi & Shuval, 2005). On the micro-level, research is more limited.…”

“…Another relatively underresearched area is the intra-, rather than inter-, professional boundaries within occupations, despite the potential importance of professional fragmentation noted above (again, there are exceptions: Zetka, 2001;McDonald et al, 2007;Sanders & Harrison, 2008). Differential status between medical specialities has a long history (Klein, 2006), and the split between GPs and specialists is a particularly entrenched one.…”

The Hunt for Red Flags: Human Resource Perspectives on Internet-based Job Candidate Screening

“…The skill-biased technological change thesis posits that organizational adoption of ICTs brings greater economic returns to highly skilled workers than to their less-skilled counterparts (e.g., Bauer and Bender 2004;Fernandez 2001). Other approaches see the outcomes of technological change as contingent on jurisdictional negotiation between different worker groups (e.g., Vallas 2001;Zetka 2001). These approaches are united by an emphasis on intra-organizational processes in which firms adopt new technology and on the consequences of these dynamics for the redistribution of economic rewards.…”

“…Vallas' (2001) research on paper mills showed how technological change shifted perceptions about the types of knowledge that were most valuable to everyday plant operations, leading to a complex series of interactions that ultimately increased inequalities between engineers and manual workers. Other research has shown how decisions to adopt and/or reject new technology result from everyday working relations and larger power struggles between different and unequal occupational groups (Novek 2002) and also transform these relations and struggles, sometimes with significant longterm consequences for the occupations involved (Zetka 2001). …”

Journalism and Blogging

“…Objective qualities mostly come from beyond the occupation. They include efforts by rival occupations to expand their jurisdictions, changes in technologies, relative financial health of an industry or of the organization in which occupational members work, the size, structure, and ownership of organizations, relationships with community and institutions on which occupations depend, and government and legal constraints (Abbott, 1988;Freidson, 1994;Larson, 1977;Weeden, 2002;Zetka, 2001). This list includes factors presently pressuring journalism, such as technological innovation, public ownership, and the changing nature of competition.…”