What Is ‘Good Doctoring' – in the Perspective of Antibiotic Resistance As a Global Issue?

In the new millennium the proliferation and mutation of antibiotic resistant bacteria has become a global health problem. Are we facing “the end of modern medicine as we know it?” This paper is purposed to examine how professional medical practices govern and control current prescription of antibiotics in Danish primary care and how notions of ‘good doctoring’ may be relevant for understanding the handling and care of patients. In particular, this paper explores changing jurisdictions (Abbott 2005), normative registers of health care practices and transformative capacities of diseases in clinical settings (Mol 2009; Mol and Law 2004).

The objective is to contribute new insights on the intra- and inter-professional responses to, and dynamics within, an emerging jurisdiction of the medical profession, related to not only individual patients’ health problems but also global health problems such as AMR. It is examined how general practitioners (GPs) are mobilised to reduce the risk of developing AMR and how they manage dilemmas in clinical practice if and when decisions about antibiotic prescriptions cannot be based on facts about molecular conditions.

One key jurisdictional dynamic analysed in this paper is: How is jurisdictional labour maintained in professional practice and organization, when for example so-called ‘wait-and-see prescriptions’ are used, where patients are supposed to decide whether or not an antibiotic cure will be relevant for them or their kids to undertake?

Empirical materials include documents (standard procedures, registration forms a.o.) and qualitative in-depth interviews with GPs and key persons about goals, dilemmas and practices. This paper mainly draws on the GP interviews. It is demonstrated how GPs understand and engage with the challenges of AMR in regards to: (i) descriptions of the common practices and tasks in medical profession and (ii) understandings and opinions of professional practitioners about the global health issue of antibiotic resistance.