Remembering My Hat

7th January 2010

To see ourselves as others see us

The other day a Physiotherapist asked me what I lectured in. I replied ‘Health and Social Care’ and she responded:

“We did 13 weeks on health and social care in my degree. We had to write an essay about treating everyone equally. I was, like, ‘I’ve got to memorise every muscle in the body, I haven’t got time for this. I promise I will treat everyone equally, just let me get on with this’.”

I was very amused by her perception of what constitutes the discipline of health and social care and it made me think about how I would characterise it.

Understanding Health and Social Care: An Introductory Reader - Published in Association with the Open University

I’m starting here from the assumption that, as for all academic disciplines, the main way you can distinguish it from other disciplines is the way practitioners (academics, researchers, students) describe themselves, and reference the literature, debates and issues that everyone else references. Or put, more positively, the academic discipline of health and social care is a discourse community. So what are the major feature of the discourse community called ‘health and social care?’

I recognise the focus on equality as a key concern, although I’m disappointed that she seemed to have no perception that there is anything systematic or difficult about inequality. I’d hope that students of health and social care come away with some understanding of the ways it’s not just about being nice to people.

I think I’d say that understanding the major features of the current provision of health and social care, including the history from which it arises (as overviewed in Block 6 of K101), is important. So things like the (somewhat arbitrary) division between health and social care; the historic privileging of health, and especially hospital based, care over secondary health care and especially social care; the implications of the changes in funding systems; the loss of trust in professionals and the increased demand for input from service users [1]; the evidence-based practice movement and its limitations. What else?

A focus on particular client groups, such as people with learning difficulties, older people or mental health service users is common, and is often the route by which people move into the study of health and social care more generally, but I’m not sure that’s essential. You would need detailed study of the particular issues affecting those groups to study Learning Difficulty or Gerontology or Mental Health Issues, but I don’t think it’s core to Health and Social Care.

I don’t think I’d say there are distinctive research methods or methodologies for health and social care, although participative/user-controlled/action/change-oriented types of research are more common than in many other fields. Likewise, there aren’t distinctive epistomological or theoretical starting points, although vaguely constructionist approaches seem particularly common.

What else?

I was also amused and discouraged in equal measure by her privileging of the concrete and physical (‘every muscle in the body’) over the wiffly-waffly interpersonal stuff. It reminded me of the privileging of the quantitative over the qualitative, which is one of my major beefs with the evidence-based practice movement.

[1] Not failing already, deliberately using this term here, since the policy generally still does.

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3 Comments »

  1. It reminded me of the privileging of the quantitative over the qualitative, which is one of my major beefs with the evidence-based practice movement.

    Yes – I was thinking of “you get what you measure”. There might be an exam on muscles of the body! which connects up, I think.

    though I’m also thinking that there’s nothing about “evidence” which justifies neglecting the qualitative… how people describe their experience is evidence too.

    Comment by Jennifer — 8th January 2010 @ 09:34 | Reply

  2. Yes, I hope her essay on health and social care at least contributed to her final degree marks (assessment defining the de facto curriculum as it does).

    > how people describe their experience is evidence too.
    Quite. I see one of my favourite articles about this is now available in Google books (apols for terrible url):

    http://books.google.co.uk/books?id=1npwXkCZxyAC&pg=PA103&dq=Little+numbers+evidence+gentle+critique&lr=&cd=1#v=onepage&q=Little%20numbers%20evidence%20gentle%20critique&f=false

    Comment by rememberingmyhat — 11th January 2010 @ 18:17 | Reply

  3. [...] because of her previous framing of anatomy as the central knowledge of physiotherapy, I had been thinking of the discipline as quite bio-medically oriented and positivist. But she [...]

    Pingback by Conversations with my Physio: Part Two « Remembering My Hat — 27th January 2010 @ 16:36 | Reply


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