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LaTonya J. Trotter

Assistant Professor of Sociology

How do changes in the organization of medical work reflect and reproduce social inequality?

I am an ethnographer and sociologist of medicine whose work explores the relationship between changes in the organization of medical work and the reproduction of gender, racial, and economic inequality.

My first book, More than Medicine: Nurse Practitioners and the Problems They Solve for Patients, Health Care Organizations, and the State, investigates the rise of the nurse practitioner (NP) in the health care encounter. Nurse practitioners have been put forth as a solution to the rising cost of care and the growing scarcity of physician labor. In More than Medicine, I investigate the shape of that solution through ethnographic attention to a group of NPs as they cared for 400 African-American older adults living with poor health and limited means. In addition to bodily complaints, these NPs addressed a broad range of social and organizational problems from inside the clinic encounter. Although normally conceptualized as physician substitutes, these NPs found themselves caught in a gendered web of obligation to do more than medical work. I also speak to the provenance of this expanded set of complaints by showing how the problems found in the NP’s exam room are as much a product of our nation’s disinvestment in social problems as of economic or personnel shortfalls.

I am currently working on a new fieldwork project where I explore the rise of nursing home alternatives for older adults such as assisted living facilities and subsidized retirement communities. Through ethnographic inquiry, I explore the organizational logics through which care work, medical work, and responsibility are being reconstituted in these new organizational forms, as well as the ways in which this reconstitution may reproduce entrenched forms of inequality in older adulthood.