Establishing specialty jurisdictions in medicine: the case of American obstetrics and gynaecology 2011 - Sociology of Health & Illness

Abstract

The profession of medicine has evolved into an extremely specialised occupation.

Yet, recent research has neglected the intra-occupational processes influencing medical specialisation.

This article aims to correct this oversight.

It develops an historical account of intra-occupational factors influencing the decision to establish gynaecologic oncology as American ob/gyn’s surgical subspecialty in 1972. Working within the framework initially developed by Everett C. Hughes and his students, the article examines this development as the outcome of a three-party relationship among gynaecologic oncologists, American ob/gyns, and gynaecologic pelvic surgeons.

Aggressive movement by the gynaecologic pelvic surgeons challenging the established élite’s identity definition for the ob/gyn specialty helped spur official recognition of gynaecologic oncology, a less threatening subspecialty. The article draws theoretical implications from the case regarding the role of a threatening other in influencing the specialisation process.