Theorising the Experiences of Professionals in Their Handling of Uncertainty through ‘Risk': Towards a Sociology of Risk Work in Healthcare

The handling of uncertainty is in many ways defining of professional power and of experiences of professional work. In health and social care, the proliferation of political drives for evidence-based (population-level and preventative) approaches to handling uncertain health futures via ‘risk’ has  resulted in changing roles for existing healthcare professionals and an increase in new types of workers (lay, peer, and para-professionals) tasked with intervening in ‘at risk’ or ‘risky’ communities and individuals. The literature has, to date, focused on organisational processes, accountability structures and the impact of risk knowledge on the experiences of patients, service-users and publics. More neglected, however, are the experiences of professionals and other health workers within these new approaches to healthcare and how they make sense of and practically accomplish the various forms of ‘risk work’ required of them. Located at the intersection of sociological studies of professions, work, risk and health, this paper develops a theoretical framework which will inform future research into risk work in various settings. Forms of risk work in health care vary – for example, screening and risk assessment, health promotion and education, and community outreach work– yet certain common experiences and related tensions are apparent: a) interpreting and applying probabilistic knowledge based on tendencies across populations within the contexts of individual cases; b) conveying this interpretation of risk to patients/public or colleagues amidst the moral consequences of such judgements; c) building rapport or relationship with patients/public which is vital for, and yet challenged by, ongoing assessments and/or communication of risk. Located within post-phenomenological scholarship, our framework focuses on how these tensions are practically negotiated, and the nature of the embodied, lived experiences of these tensions in everyday work. Recently collected pilot data drawn from risk work practiced in contrasting settings are drawn on in informing and illustrating our framework.