Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce

Efforts to ‘modernize’ the clinical workforce of the English National Health Service have sought to reconfigure the responsibilities of professional groups in pursuit of more effective, joined-up service provision. Such efforts have met resistance from professions eager to protect their jurisdictions, deploying legitimacy claims familiar from the insights of the sociology of professions. Yet to date few studies of professional boundaries have grounded these insights in the specific context of policy challenges to the inter- and intra-professional division of labour, in relation the medical profession and other health-related occupations. In this paper we address this gap by considering the experience of newly instituted general practitioners (family physicians) with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care. Using qualitative data from four comparative case studies, we discuss how an established intra-professional division of labour within medicine—between clinical geneticists and GPs—was opened, negotiated and reclosed in these sites. We discuss the contrasting attitudes towards the nature of genetics knowledge and its application of GPSIs and geneticists, and how these were used to advance conflicting visions of what the nascent GPSI role should involve. In particular, we show how the claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary than the rhetoric of modernization might suggest.

Inductive Theorem Proving and Computer Algebra in the Mathweb Software Bus

Reasoning systems have reached a high degree of maturity in the last decade. However, even the most successful systems are usually not general purpose problem solvers but are typically specialised on problems in a certain domain. The MathWeb SOftware Bus (Mathweb-SB) is a system for combining reasoning specialists via a common osftware bus. We described the integration of the lambda-clam systems, a reasoning specialist for proofs by induction, into the MathWeb-SB. Due to this integration, lambda-clam now offers its theorem proving expertise to other systems in the MathWeb-SB. On the other hand, lambda-clam can use the services of any reasoning specialist already integrated. We focus on the latter and describe first experimnents on proving theorems by induction using the computational power of the MAPLE system within lambda-clam.