Accessing care: Technology and the management of the clinic

In this chapter we focus on our field studies of different clinical spaces in one large UK regional teaching hospital and how they perform different, yet, perhaps, complementary kinds of ‘medicine’: emergency, genetic and critical care medicine. We focus on those moments and processes through which patients do, or do not, gain access to the diagnostic categories, treatment and care provided by these different services. In particular, we emphasise the alignment of managerial and clinical technologies in the production and reproduction of these medical specialisms and show how gaining access to care is a critical site for exploring how and what clinical work performs in terms of mundane processes of exclusion and inclusion, and contemporary cultural and social preoccupations, such as choice (Osborne and Gaebler, 1993; Self, 1993), health (Tudor Hart, 2006) and auditability (Power, 1999; Strathern, 2000).