Menchik, Daniel (2021). Managing Medical Authority

Sociologists interested in professional jurisdiction and power have often turned to physicians as an empirical case. How did allopathic medicine beat out its competitors to become the defining professional group over our experiences of illness and the body? This question is reinvigorated in Daniel Menchik’s new book, Managing Medical Authority. Menchik analyzes an astonishing 12 years of ethnographic data to develop an account of the machinations of authority among cardiologists and their more specialized peers, electrophysiologists. Menchik situates his account in a deep theoretical tradition on how physicians maintain professional authority. At stake in what constitutes a profession is its members’ ability to define problems and establish themselves as the ideal experts to solve such problems. Physicians as a professional group must defend their authority from interlopers—like health insurance or pharmaceutical industries—which have multiplied and intensified around the medical profession since the 1980s. Rather than focusing on how authority is established, Menchik focuses on how physicians continuously manage their authority through status-seeking behaviors. Indeed, as Menchik demonstrates convincingly, interlopers can be a source of not just competition for authority but collaboration and coordination. Menchik’s major theoretical contribution is what he calls “organizing indeterminacy.” Organizing indeterminacy attends to the dynamics by which cardiologists—and, indeed, physicians more broadly—define problems and their solutions. According to Menchik, cardiologists maintain their authority through their ability to set the terms of the problems into Book Reviews