‘Pathways to the Doctor’ in the Information Age: the Role of ICTs in Contemporary Lay Referral Systems

Abstract

Just over three decades ago Zola (1973) published a paper with the title ‘Pathways to the Doctor: from person to patient’. This seminal work became one of the most influential and cited articles in medical sociology. Based on an empirical analysis of patients’ accounts of their reasons for attending a hospital outpatients in the USA Zola identified his five now famous ‘triggers’ (see below), which prompt consultation with formal health care providers. But of course there have been substantial socio-economic, political and technological transformations since Zola carried out his fieldwork. The late 1960s and early 1970s was a period that is characterised as being an era of Fordism, modernism, professionalism, industrialism and so on. This is in contrast to the post-Fordist, late modern, consumerist, information age which is presumed to more accurately capture the features of contemporary life. The aim of this chapter is to reconsider the work of the likes of Zola and his contemporaries in order to assess whether and to what extent his analyses of ‘pathways to the doctor’ still have any analytic purchase in relation to people’s routine experiences of health care. The chapter argues that while continuities can be discerned over the last 30 years there are also changes; imperceptible perhaps at the level of everyday practice but occurring nevertheless.