Who Empowers Who in Co-production? Surgeons' and Patients' Power Dynamics throughout Clinical Decision Making

Yvonne La Grouw*, Sierk Ybema, Duco Bannink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Co-production tends to assume that co-produced decision-making leads to consensus and equality between actors with different perspectives. Drawing on ethnographic insights into interactions between professionals and patients, this article studies how consensus and equality may manifest in the professional-patient interaction throughout co-produced decision making. Characterized by three power dimensions and structured by problem-based and relation-based reasonings, our findings show how the interactions remained unequal and were directed towards seeking consent instead of consensus. These findings deepen our understanding of professional-patient interaction, not only of co-production but also of street-level work.
Original languageEnglish
Pages (from-to)533-562
Number of pages30
JournalAdministration and Society
Volume57
Issue number4
Early online date25 Feb 2025
DOIs
Publication statusPublished - Apr 2025

Bibliographical note

Publisher Copyright:
© The Author(s) 2025.

Keywords

  • Co-production
  • Expert and lay knowledge
  • Power dynamics
  • Professional-patient interaction
  • Public service delivery
  • Shared decision making

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