Paper short abstract:

This paper explores structures of muting and institutional prejudice within prestige hierarchies in medicine. Solid, biomedical epistemologies are examined and fluid alternatives suggested to better serve patient-centred healthcare.

Paper long abstract:

Prestige hierarchies are taken for granted in clinical medicine. From the earliest days, medical students and doctors are enculturated into a professional hierarchy which whilst effective on some levels has also been associated with institutional prejudice and the muting of the voices of those who are considered subordinate. A recent study of 163 Melbourne doctors found that less than half were willing to question a 'superior doctor' even if an error was occurring. (Dendle et al, 2013)

Co-authored by five medical students who use an anthropological framework to explore medical hierarchies, this paper examines medical prestige from the perspective of solid epistemologies as are commonly found in biomedicine and the associated muting of voice which can ensue. It suggests that alternative fluid models exist which better serve an evolving paradigm of patient-centred medical care.