What is ‘Good Doctoring’ When Antibiotic Resistance is a Global Threat?

  • Inge Kryger PedersenEmail author
  • Kim Sune Jepsen


This chapter presents results from an exploratory enquiry into ‘good doctoring’ in the case of antibiotic prescribing. Drawing on 21 in-depth interviews with Danish general practitioners (GPs) about diagnosing and prescribing, the chapter demonstrates how GPs manage dilemmas in clinical practice if and when decisions about antibiotic prescriptions cannot be based on facts about molecular conditions. In this light, the chapter identifies how GPs understand and evaluate jurisdictional boundaries, that is, how they control and apply their expert knowledge in regard to the public health issue of antibiotic resistance. This chapter contributes insights into new jurisdictional tasks in a risky environment and concludes that the broader external forces of global antimicrobial resistance must be seen as shaping medical practice in the locations of primary care.


  1. Aabenhus, R., Siersma, V., Hansen, M. P., & Bjerrum, L. (2016). Antibiotic prescribing in Danish general practice 2004–2013. Journal of Antimicrobial Chemotherapy, 71(8), 2286–2294.CrossRefGoogle Scholar
  2. Abbott, A. (1988). The system of professions: An essay on the division of expert labor. Chicago: University of Chicago Press.Google Scholar
  3. Abbott, A. (2005). Linked ecologies: States and universities as environments for professions. Sociological Theory, 23(3), 245–274.CrossRefGoogle Scholar
  4. Armstrong, D., & Ogden, J. (2006). The role of etiquette and experimentation in explaining how doctors change behaviour: A qualitative study. Sociology of Health & Illness, 28(7), 951–968.Google Scholar
  5. Beck, U. (1992). Risk society. Towards a new modernity. London: Sage Publications.Google Scholar
  6. Beck, U., Giddens, A., & Lash, S. (1994). Reflexive modernization. politics, tradition and aesthetics in the modern social order. Cambridge: Polity Press.Google Scholar
  7. Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Thomson, M. A. (1998). Getting research findings into practice: Closing the gap between research and practice: An overview of systematic reviews of interventions to promote the implementation of research findings. BMJ: British Medical Journal, 317(7156), 465–468.CrossRefGoogle Scholar
  8. DANMAP. (2013). DANMAP 2013—Use of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from food animals, food and humans in Denmark. The Danish Integrated Antimicrobial Resistance Monitoring and Research Program. Copenhagen: Statens Serum Institute.Google Scholar
  9. EC. (2012). Council conclusions on the impact of antimicrobial resistance in the human health sector and in the veterinary sector—A “One Health” perspective. Brussels: The Council of the European Union.Google Scholar
  10. Hacking, I. (1990). The taming of chance. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  11. Larsen, L. T. (2016). No third parties. The medical profession reclaims authority in doctor-patient relationships. Professions & Professionalism, 6(2), 1–14.CrossRefGoogle Scholar
  12. Lugtenberg, M., Zegers-van Schaick, J. M., Westert, G. P., & Burgers, J. S. (2009). Why don’t physicians adhere to guideline recommendations in practice? An analysis of barriers among Dutch general practitioners. Implementation Science, 4(54), 1–8.Google Scholar
  13. Lundkvist, J., Akerlind, I., Borgquist, L., & Mölstad, S. (2002). The more time spent on listening, the less time spent on prescribing antibiotics in general practice. Family Practice, 19(6), 638–640.CrossRefGoogle Scholar
  14. Pedersen, I. K., & Jepsen, K. S. (2018). Prescribing antibiotics: General practitioners dealing with “non-medical issues”? Professions & Professionalism, 8(1), 1–14.CrossRefGoogle Scholar
  15. Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ: British Medical Journal, 312(7023), 71–72.CrossRefGoogle Scholar
  16. Stivers, T. (2007). Prescribing under pressure: Parent-physician conversations and antibiotics. Oxford: Oxford University Press.CrossRefGoogle Scholar
  17. Struhkamp, R., Mol, A., & Swierstra, T. (2009). Dealing with in/dependence. Doctoring in physical rehabilitation practice. Science, Technology, & Human Values, 34(1), 55–76.CrossRefGoogle Scholar
  18. Thévenot, L. (2001). Organized complexity. Conventions of coordination and the composition of economic arrangements. European Journal of Social Theory, 4(4), 405–425.CrossRefGoogle Scholar
  19. Timmermans, S., & Kolker, E. S. (2004). Evidence-based medicine and the reconfiguration of medical knowledge. Journal of Health and Social Behavior, 45(Suppl), 177–193.Google Scholar
  20. Wahlberg, A., & Rose, N. (2015). The governmentalization of living: Calculating global health. Economy and Society, 44(1), 60–90.CrossRefGoogle Scholar
  21. Weiss, M., & Fitzpatrick, R. (1997). Challenges to medicine: The case of prescribing. Sociology of Health & Illness, 19(3), 297–327.CrossRefGoogle Scholar
  22. WHO. (2014). Antimicrobial resistance: 2014 global report on surveillance. Geneva: World Health Organization.Google Scholar
  23. Woolf, S. H., Grol, R., Hutchinson, A., Eccles, M., & Grimshaw, J. (1999). Potential benefits, limitations, and harms of clinical guidelines. BMJ: British Medical Journal, 318(7182), 527–530.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.Department of SociologyUniversity of CopenhagenCopenhagenDenmark
  2. 2.Department of SociologyLund UniversityLundSweden

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