THE INFLUENCE OF CLINIC ORGANIZATIONAL FEATURES ON PROVIDERS’ ASSESSMENTS OF PATIENT ADHERENCE TO TREATMENT REGIMENS

This study uses ethnographic data from two diabetes clinics to examine how some organizational features of medical settings are connected to the daily cognitive and interactional work of medical providers – specifically, the process of assessing patient adherence and using such assessments to make treatment decisions. I address continuity of care, scheduling and time constraints, team management, provider interaction, and medical recordkeeping as organizational-level issues that impact individual-level providers’ work. More than a top-down model of how “macro” influences “micro,” this study highlights how organizational influences are accounted for in terms of variation in patients’ behavior.