Changing realities and entrenched norms in dialysis: A case study of power, knowledge, and communication in health care delivery

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Book Chapter

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In this chapter, I explore two macro-level trends in health care in order to demonstrate how they manifest themselves through mundane daily communication in a particular health-care setting. First, health-care communication norms developed based upon an acute care model and poorly serve health-care providers who face an ever-increasing need to manage ongoing treatment for people living with multiple chronic illnesses. Second, traditional professional disciplinary hierarchies and boundaries persist in the face of a changing workforce and enormous reliance on skilled but not formally educated paraprofessionals (e.g., technicians, nursing assistants) to provide the vast majority of hands-on patient care. By examining how these systemic trends play out on a micro level, this chapter proposes that the U.S. health-care system perpetuates a hegemonic power structure that makes superficial stylistic changes to adapt to consumer demands while reinscribing the norms of biomedical power.

Chapter of

Emerging perspectives in health communication: Meaning, culture, and power


M. Dutta
H. Zolle

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