The Role of Technology and Expertise in Clinical Decision-Making: Insights from Hospital Ethnography in India

In contemporary healthcare, the dynamics of medical decision-making are deeply intertwined with scientific expertise and advanced technologies. The rise in medical technologies has brought about a revolutionary change among healthcare practitioners in treating patients. This study explores the intricate dynamics of medical decision-making within neurosurgery, focusing on the treatment of traumatic brain injuries (TBIs). Conducted at a tertiary care hospital in Southern India, the research employs ethnographic methods including in-depth interviews with neurosurgeons and allied medical professionals such as neuro-radiologists, neuro-anesthetists, and neuro-psychologists. This study examines how neurosurgeons negotiate between their clinical expertise, technological inputs, and institutional constraints and deal with medical uncertainties while making critical treatment decisions for patients with traumatic brain injury (TBI). Central to this analysis is the role of diagnostic technologies such as MRI and CT scans in shaping clinical decision-making processes. These technologies serve not only as diagnostic tools but also play a pivotal role in the training and transfer of medical knowledge to the next generation of doctors. Furthermore, the advancement of neuroscientific research is increasingly driven by the use of sophisticated devices and machinery. This study critically explores how neurosurgeons juxtapose imaging and scan reports with their clinical acumen to arrive at the best treatment decisions. Thus, the study highlights the importance of understanding how technological and scientific expertise is mobilized within institutional contexts offering valuable insights into the sociology of health, science, and technology. It offers insights about the interaction between human expertise and technological systems in shaping patient outcomes and underscores the importance of interpreting medical decision-making within a hospital setting.