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Since the very emergence of the information technologies in healthcare, a major concern has been raised about the potential of remote services to undermine the intimacy, immediacy and humanity intrinsic to conventional, face-to-face medical practice. By contrast, notable literature reports the benefits of information technology–mediated services and their potential to improve efficiency and economic convenience of healthcare systems. This article aims to shed light on this ambivalence by retracing the evolution of doctor–patient interaction in relation to the main technological advancements in healthcare, and in particular, to services mediated by information technologies. Consequently, the reduction of cues and clues associated with the use of these services is framed into the reductionism of the biomedical paradigm, which provides a key to interpret the nature, scope and features of this process of technological innovation, along with its potential and limits. [ABSTRACT FROM AUTHOR]

This article examines how Australian providers of unproven autologous 'stem cell treatments' legitimise these products and their practices. We focus on the strategies employed by providers in their efforts to create and sustain a market for procedures that have yet to be proven safe and clinically efficacious. Drawing on the work of Thomas Gieryn and Pierre Bourdieu and the findings of research involving an analysis of direct-to-consumer online advertising of clinics that sell purported 'stem cell treatments' and interviews with clinicians who provide them, we examine the mechanisms by which medical legitimacy for these products is established and defended. We argue that Australian providers employ a number of strategies in order to create medical legitimacy for the use and sale of scientifically unproven therapies. A key strategy employed by providers of stem cell treatments is to use markers of social distinction, drawing strongly on the symbols of science, to confirm their legitimacy and differentiate their own practices from those of other providers, who are posited as operating outside the boundary of accepted practice and hence illegitimate. We argue there is a paradox at the heart of the autologous stem cell treatment market. Providers aim to create legitimacy for their work by emphasising the potential benefits of their 'treatments', their expertise and the professionalisation of their practices in an environment where regulators are yet to take a firm stance; they are also required to undertake the challenging task of managing patients' hopes and expectations that both enable and potentially jeopardise their operations and revenue. We conclude by suggesting that providers' creation of symbolic capital to establish medical legitimacy is a crucial means by which they seek to bring unproven 'stem cell treatments' from the margins of medicine into the mainstream and to portray themselves as medical pioneers rather than medical cowboys who exploit vulnerable patients. [ABSTRACT FROM AUTHOR]

Conferences are novel sites for understanding medical work. Through describing styles of presentation that take place at conferences attended by patients and parents, this article highlights how clinicians on stage present ordinary and extraordinary aspects of medicine. Attention is drawn to the reaction of the parents in the audience. The power of the presenter to direct proceedings highlights the potential vulnerability of the audience. The relationship between clinician on stage and parents in the audience reflects the clinical relationship between doctor and patient. But through identifying insiders and outsiders, the conference setting also enables new relationships and collective identities to be formed. Drawing on an ethnographic study of rare disease conferences, this article extends understanding of medical work by identifying how conferences offer new ways of witnessing the clinical gaze, the doctor–patient relationship and the formation and enactment of a conference community. [ABSTRACT FROM PUBLISHER]

Patients commonly experience some physicians' ways of interacting with them as detached and indicating a lack of concern for their welfare. This is likely to add to the distress experienced by a person seeking healing, as well as interfering with the exchange of information required for good medical care. Despite contemporary medical schools' focus on clinical communication, and on training for 'patient-centred' practice, problems with the relations between doctors and patients are still widely acknowledged. The importance of demonstrating empathy, compassion and caring has been highlighted in the literature. In this article I draw on a clinical narrative to elucidate my interpretation of engagement, which entails practices of attentiveness, respectful dialogue and commitment. I propose that practising engagement may help medical students and doctors to infuse their clinical encounters with empathy and compassion, with the aim of providing care that is experienced as being more humane. This practice has the potential to contribute to innovative pedagogical approaches to clinical communication. [ABSTRACT FROM AUTHOR]