Interprofessional Conflicts in Home-Care: The Case of The Provincial Health Authority of Cosenza (Italy)
Pietro Paolo, Guzzo
Law Science (Calabria University)- Learning Science (Palermo University) University of Calabria- University of Palermo Arcavacata di Rende- (Cs) Italy, Italy
The Health Care and Social Service Professions (Freidson , 1970; Jhonson, 1972; Abbott, 1988; Tousijn, 2004; Venneri, 2003; Edman, 2001) are always at the core of intense transformation processes. Interprofessionality is a principle that should guide the processes of learning between social and health professionals but more often it is the weak point of the welfare systems (Hudson, 2005). I see the usefulness of putting beside studies in international literature about IP (D'Amour and Oandasan, 2005) also a sociological analysis of the conflicts in the IP-work of treatment (Tognetti - Bordogna, 2008). Often they are conflicts mediated by the law (Tomeo,1981), and that on a daily basis debate the diverse social and health professions (doctors, nurses, social workers, therapists, etc.) who are involved in treatment that is dispensed through team work. I will present in heuristic key a theoretical model of Sociology for interprofessional conflicts that intertwine between cycles of institutional integration/ disintegration professionals and intermediation/ disintermediation of knowledge and professional systems. I outline four phases of interprofessional conflict: irreversible; segregating; integrating; transforming. Ultimately I use this model to conduct a case study that I carry out in a particular social health setting: the service of integrated assistance at home (Assistenza Domiciliare Integrata A.D.I.) of the Provincial Health Authority of Cosenza. The study reflects on the recordings of possible situations and dynamics of conflicts between professionals that carry out treatment at home. I interview privileged witnesses from different professions (doctors, nurses, social workers, etc.) in the ADI -teams on the themes circumscribed through a previous in situ observation of the participants. In this direction to identify profiles and phases of the interprofessional conflict in a Health Authority of vast geographical dimensions and with a large number of users, in a region like Calabria that answers to the description of having a welfare which is fragile and divided up. In this specific direction the essay is an experiment, halfway between Sociology of Law and Sociology of Health with particular reference to the theme of the health professions involved in the conflicts that arise from assistance and treatment.