My research examines stability and change in professional fields by bridging rarely integrated subfields—sociological theories of organizations and medicine and socio-legal theories of criminality and frontline work. Primarily using qualitative, ethnographic methods, I concentrate on pharmacy, a highly understudied profession caught in the crossfires of contemporary political conflict. I focus on two particularly controversial types of drugs: emergency contraceptive pills and narcotics. Though these drugs serve very different physical functions, they are subject to overlapping social contexts and similar mechanisms of resistance by political groups. I examine these forces via two related research projects.
Institutional Influences on frontline decision-making
This project highlights how pharmacists act as key agents of social control by constructing four gatekeeping roles—medical, legal, fiscal, and moral—and enacting them differently across organizational settings; how pharmacists rely on patients’ behavior and characteristics, as well as broader cultural messages, to assess patients’ "deservingness" and decide whether to provide care; and how professional “contingency” (i.e. a state in which one profession’s scope of practice depends significantly on that of another profession) shapes inter-professional dynamics, especially the mobilization of third parties in decision-making. This research received an honorable mention for the Outstanding Dissertation Award from the ASA’s Medical Sociology Section.
COMPETING INSTITUTIONS: HEALTHCARE AND CRIMINAL JUSTICE
This project uses the case of prescription drug abuse to examine how two institutional fields—healthcare and criminal justice—grapple with the same social problem. I examine how distinct framing, routines, and goals lead institutional actors to work with and against each other, how the emergence of new technologies in the form of state-level “Prescription Drug Monitoring Programs” affect professional decision-making and the surveillance of patients and providers, and the implications of current efforts to combat misuse for inequalities in both access to care and exposure to the criminal justice system. This research involves undergraduate research assistants and has received support from Saint Louis University's Stroble Award in the Health Sciences.
My research has been generously supported by the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality, the ACLS/Mellon Foundation, Saint Louis University Office of the President,Princeton University's Office of Population Research, Princeton University's Center for Health and Wellbeing, the University California, Irvine's Center for Organizational Research, and the University of California Office of the President Labor and Employment Fund.