Classification of Practitioners by Urban Chicano Patients

This study in the sociology of lay knowledge seeks to conceptualize the “everyday rules” by which a patient makes choices about which practitioner should be consulted for which episode. A lay person must often choose a practitioner from among competing coteries of specialists, without having recourse to their specialized knowledge in order to classify them. The patient must develop her own typology of specialists, utilizing her own criteria. The patient becomes aware of a number of aspects of an episode, each of which requires a response of some sort. In the course of her interaction with a practitioner, the patient discovers that the practitioner is competent, in her perception to handle some aspects and inadequate to handle others, thereby presenting her with a particular constellation of competencies and inadequacies. When seeing different practitioners, the patient encounters vertical and horizontal conflict between the assessments offered her by each. She must decide which offers the competencies most needed and the inadequacies most tolerable. A practitioner's constellation may change over time or by episode. In order to secure the competencies she feels necessary, the patient may utilize a number of practitioners either sequentially or simultaneously, thereby functioning as an assembler of her own health care team.