Una adopció a l’ombra de la professió: la revisió de la innovació mèdica

Sociologists and marketing researchers have studied the now-classic question of whether and how networks affect the adoption of innovations. Prior studies have focused on the diffusion of single-item innovations, such as the decision to adopt a single drug (tetracycline) or a consumer item (a stove, an internet health forum). We return to the original sociological question of innovation adoption seen through the lens of the medical profession, and claim a substantive need exists to focus on the multifaceted nature of the adoption choices professionals face. We conduct an abductive study that at its core contains a vignette-based survey presenting the exact same hypothetical patients to specialists across two countries and two rare cancers. We find significant residual variance in medical specialists’ adoption across multiple prescribing options, and show this residual variance correlates with features of the formal and informal structure of the system of professions. In contrast to prior single-item adoption research, no single variable in the informal structure of the profession has explanatory power across the true spectrum of adoption options. We propose that adoption by the medical profession might be better informed by theories of professional reform than by classic marketing research, and that a network theory of adoption will need to further integrate node-level concepts with studies of the network as a whole if it is to explain adoption in the shadow of the profession.