Travelling knowledge: the glocalization of medical professional knowledge and practice

Abstract Booklet
(by authors in alphabetical order)

Hannah Bradby, Uppsala University
Medical authority and globalized migration: racism, de-prioritization and vulnerability
Drawing on interviews with minority and migrant staff in the Swedish healthcare system
this talk considers how racism plays out in working lives. Interest is paid to the ways that
racism against patients is hidden from view through de-prioritisation as a version of legitimate
medical practice. The subtle nature of clinical decision-making means that space
opens up for unwarranted discrimination. The duty of care towards the patient, even if
racist, together with a widespread reluctance to acknowledge racism as a routine part of
healthcare practice, makes it difficult for staff to discuss how to protect themselves in professional
settings. Until the space that medicine allows for racialisation processes to play
out is acknowledged, it is difficult to establish anti-racist work-place practices to protect
staff and patients alike.

Lucia Candelise, Antoine Kernen and Jean-Marie Opplinger, all University of Lausanne
Chinese medicine in Cameroonian medical pluralism. The reappropriation of Chinese medical
practices and product by Cameroonian therapists
Chinese presence in the African health sector can be traced back to first aid programs in
the 1970s including the construction and equipment of hospitals as well as the sending of
Chinese medical teams to many African countries. Thus, Cameroon now counts four hospitals
(in Mbalmayo, Guider, Yaoundé and Douala) built within the framework of Sino-
African cooperation. Nevertheless, more recently the circulation and the re-appropriation
of medical knowledge, practices and products coming from China by African doctors and
therapists can be put into perspective with the works on globalisation of Chinese medicine
that have shown the hybridization of knowledge and practices with other techniques,
remedies and medical knowledge, giving rise to local adaptations and “globalized forms
of knowledge”. The specific forms of Chinese medicine globalisation take in African countries
can be understood with African medical pluralism as the processes of constant reinvention
and borrowing occurring in increasingly competitive local medical markets, frequently
in tension between so-called “traditional” and “modern”.
Based on the primary results of an ongoing four-year project called “Chinese medicine in
African medical pluralism”, our intervention focuses precisely on the impact of various
and heterogenous therapeutics and products coming from China in Cameroon. Through
a qualitative study based on semi-structured interviews with Cameroonian actors, we aim
to question at different scales how Chinese presence in Africa participates in the process
of reshaping local healers’ daily practice (micro) and Cameroonian medical pluralism
(macro). We also take into account the processes of recognition and professionalisation
of local healers (meso) to observe various trends of local appropriations.

Hilal Bal Eryılmaz, Istanbul Technical University
Local Reflections of Global Trends: Anti Vaccination Movement in Turkey
Recent years, the anti-vaccination movement is on the rise globally. The trend is high in
the developed countries, however, others are catching up. Emergence of contagious disease
outbreaks which could have been prevented by vaccines is a major concern. Many
studies in the literature suggest that the main reason for resisting vaccination is because
people do not have adequate knowledge about vaccines, hence they propose expert-topublic
policy approaches. I offer a different framing to the issue. I argue that the problem
stems from current preference of scientific knowledge transfer which preserves the deficit
model of science communication. Hence, I approach the anti-vaccination movement
from STS perspective; examining the social construction of science in anti-vaxxer society
and transfer of scientific knowledge about vaccines. Here, I give Turkey as a case study to
illustrate how the bridge between global and local is being formed. My purpose is to understand
how anti-vaccine communities in Turkey interpret anti-science, mainly anti-vaccine
discourse produced outside of Turkey and transfer the anti-vaccine knowledge to
their culture. Previous studies on the anti-vaccination movement in Turkey did not take
into account the transfer of knowledge between parents, and communication between diaspora
and homeland communities. In line with globalization and rapid transfer of
knowledge, the major communication pathway is through online groups. I analyze various
online groups and their related ‘outside sources’ which shapes people’s stance on vaccination
and how the narrative between people is stronger than what scientific authority declares.
The results of this research can help health and education policies, improve health
professional-patient communication and raise overall science literacy in the future.

James Faulconbridge, Lancaster University
Variegated financial knowledge: the case of global law firms in Southeast Asia
This paper addresses the following question: How do global law firms, as business service
intermediaries, globalize knowledge and configure the financial organisation of Southeast
Asian transnational corporations (TNCs)? The paper identifies the way that global law
firms globalize knowledge by articulating financial imperatives in ways that encourage
the reproduction of Anglo-American models of financial corporate structuring. Through
their relationships with TNCs, they articulate a meta-narrative about legitimate ways of
financing activities when different types of corporate operation (e.g. merger) are performed.
The relationships and meta-narrative matter because they play a crucial role in
defining the financial ‘rules of the game’ TNCs are expected to follow. However, the paper
also explores the complex power relations associated with articulation and its effects. By
examining the way articulation relies on both ‘power over’ and ‘power with’ Southeast
Asian TNCs, the paper reveals the way that knowledges and practices are refracted. This
results in variegated knowledge effects as global actors (law firms) and local actors (their
Southeast Asian clients) interact, exercise power in doubly contingent relations, and continually
reproduce both strong (the adoption of ‘global financial architectures’) and weak
convergence (the repurposing of models and structures).

Loes Knaapen, University of Ottawa
Transnational control of standard multiplicity: competition, certification or distribution of ‘local’ standards
Science and Technology Studies (STS) scholars often highlight how diversity remains, despite
increased standardization. As standards continue to proliferate, they themselves are
increasingly multiple: local, national and international standards on the same topic;
competing private, public and multi-stakeholder standards. For example, the “uncoordinated
proliferation” of multiple organic and fairtrade labels threatens the legitimacy of
sustainability standards as a whole (Reinecke et al, 2012:804).
In this paper, I will provide an overview how the transnational control of standard multiplicity
is practiced and conceptualized. Many scholars have examined how specific standards
have been consolidated or coordinated within a distinct domain (i.e. accounting,
technology, agri-food). My aim is to contribute to the ‘Sociology of Standardization’ by
providing some conceptual tools to understand the control of standard multiplicity across
domains.

Since the late 1990s, many domain-specific international organizations have been established
with the explicit goal to manage the multitude of similar standards in their domain
(Turcotte et al, 2014). In contrast with previous transnational control of multiplicity,
these organizations do not eliminate competing standards, but regulate them, allowing
multiple standards to co-exist in a coordinated manner. This coordination is a form of
‘meta-standardization’, as it is done by establishing procedural meta-standards for standard-
setters to follow.

Others have described two distinct ways to coordinate multiplicity: competition
(Reinecke et al, 2012) and certification (Verbruggen & Havinga, 2016). Based on an empirical
case study of the Guidelines International Network (GIN), I propose distribution as
a third way to coordinate multiplicity. GIN was established in 2002 to address contradictory
clinical practice guidelines, and has done so by emphasizing the importance of local
context and cultural values as key determinants of evidence-based standards. They have
produced ‘universal’ standard-setting procedures with which to regulate ‘local’ guidelines,
but the importance of ‘local context’ makes similar standards fundamentally incomparable.

References:
Reinecke, J., Manning, S. & von Hagen, O. (2012). The Emergence of a Standards Market: Multiplicity of Sustainability Standards in the Global Coffee Industry. Organization Studies 33 (5-6):791-814.
Turcotte, M., Reinecke, J., & Den Hond, F. (2014). Explaining variation in the multiplicity of private social and environmental regulation: A multi-case integration across the coffee, forestry and textile sectors. Business
and Politics, 16(1), 151-189.
Verbruggen, P., & Havinga, T. (2016). The Rise of Transnational Private Meta-Regulators. Tilburg Law Review, 21(2), 116–143. Karin Knorr Cetina, University of Chicago

Karin Knorr Cetina, University of Chicago
Bounded Globalization and its Path Dependence: The Case of Financial Markets
Two leading distinctions have shaped globalization research: that between the local and
the global and that between a top-down perspective (Stanford, World Society perspective)
and a bottom-up view that investigates globalization in terms of the expansionary
tendencies of trade, migration etc. In this talk I bracket these distinctions and look at
bounded global forms that show remarkable internal coherence and resilience. I see this
as a meta-stability having to do with how such fields develop over time—both through
the reinforcement of earlier tendencies and through radical transformation. A case in
point is some financial markets and the three major transitions they have gone through. I
will consider these transitions and also their synthetic dimension and micro-structuration.

 

Lakshmi Krishnakumar N., SRM Institute of Science and Technology, Chennai
When the Global comes to the Local: A Study of Ayurveda in Kerala
A major part of the tourism revenue in the southern Indian state of Kerala is earned from
medical value travel. Of the various services in the therapeutic landscape of Kerala, Ayurveda
occupies a pride of place, drawing its lineage from a millennia-old medical system.
While Ayurveda has been adapted in multiple fashions throughout the breadth of the
country- in terms of its canonical texts and its institutional practice- these adaptations
have been mediated through the histories of colonialism and post-independence legislations
and policies. More recently, the rising popularity of Ayurveda in the West, starting
with the New Age movement of the 1960s, has led to the reframing of local practices also.
In addition to moving from a purely genealogically-inherited knowledge system to one
that a person can be trained in at an educational institution, the sites of practice of Ayurveda
have also expanded. Where the earliest institutions were run by families of Ayurveda
vaidyas, today, hospitals are established on the lines of biomedical hospitals, and so are
Ayurvedic resorts. In these latter sites, a shift in the practice is seen, as they cater to a
predominantly western clientele. The shift is seen not just in the practice of Ayurveda, but
in the articulation of it as well: wellness regimen or therapeutic system? As the demands
for Ayurvedic regimens increase, an attempt is made to construct a medical system that
fits into the space of non-invasive therapies, as compared to the procedures that are usually
practised in more traditional settings. The origins of these purging of certain elements
of therapy can be seen even from the Ayurvedic practices popularized during the New Age
movement. Drawing on ethnography conducted in 2018, this paper looks into the articulations
and practice of Ayurveda in spaces that cater primarily to non-local clienteles, and
to study the manner in which a medicine system adapts and modifies itself, when it comes
in contact with a new set of actors and cultures, who in turn bring with them the
knowledge of other systems of medicines.

Thomas Laux, TU Chemnitz
What makes a global movement? Analyzing the conditions for strong participation in the climate strike
The Fridays For Future (FFF) movement and their global climate strikes put climate
change on the political agenda worldwide and created a new a wave of climate activism.
Since its emergence in August 2018, FFF is especially remarkable because of its global
reach. FFF is a rare example of a true global movement not confined to particular regions
of the world or continents. A case in point is the third global climate strike (September
22–27, 2019), which saw protests in nearly all countries of the world and was the biggest
mobilization for climate protection so far, with over 6 million participants.
The emergence of a social movement on a global level is a rare and contingent phenomenon
that challenges sociology to inquire its conditions. By doing so, it enables important
insights into the processes of globalization: Global social movements are the result of
“new transnational activism” (Tarrow, 2005: 4-7) as well as the outflow of a developing
awareness of existing global interdependencies between individuals, nation states and
world society (Robertson, 1992: 8; Meyer, 2007: 263).
The study analyzes the mechanisms that have prompted strong mobilization for the climate
strike. By analyzing the mobilization from a comparative perspective, we gain insights
into the equifinal mechanisms for mobilization on the nation–state level that lead
to the emergence of a social movement. The study applies a Qualitative Comparative Analysis
(QCA) of 17 democratic countries and four mechanisms are identified, showing that
trust in environmental movements, the availability of resources through international
nongovernmental organizations (INGOs) and information and communication technologies
(ICT), and frame resonance are sufficient for explaining strong mobilization.

 

Peggy Levitt, Wellesley College and Harvard University
Transnational Education: The impact of Knowledge Production, Circulation, and Regulation
The idea that education systems as state-driven, territorially limited, and nationally
bounded is, at best, incomplete. In the United States, for example, shrinking government
resources prompt public schools to patch budget gaps by looking abroad, whether by hiring
primary school teachers from the Philippines or by recruiting full-tuition paying international
students at the university level. For countries like Mexico and the United
States with deeply integrated migration corridors, both sending and receiving states have
an interest in preparing students to retain cultural – and hopefully economic – ties. This
marks a turn from educating children as nationals to educating children as transnational
or global citizens. And for countries starved of human capital, convincing their citizens
not simply to move abroad to gain experience but to return home to use it for the good of
the nation is of utmost importance. Taken together, these changes have serious implications
for how individuals, states, and both private and public institutions understand opportunity,
citizenship, and options for social protection.
These changes in the education sector are enormous. They encompass primary, secondary,
and tertiary education as well as teachers, learners, recruiters, evaluators, and regulators.
They involve migration-driven education and education-driven migration. Education-
driven migration includes people who go abroad to study in search of educational
opportunities that are better than those available back home. Migration-driven education
includes education to meet the needs of migrants and their children. Untangling the effects
of a globalized education sector from changes produced by transnational migration
is often difficult because the two are deeply entwined. In this talk, I will discuss the impact
of these changes on the training of educational and health care professionals, where they
put these skills to use, and the goodness of fit between the training they receive and the
populations that they serve.

Tao Liu and Benjamin Quasinowski, University of Duisburg-Essen
The standardization of heart failure in clinical practice guidelines and the rise of a global cardiology community in the world society
In connection with the neo-institutional world polity theory (John W. Meyer) we argue
that cardiology has increasingly become a global field over the 20th century. In part this
is due to the spread of cardiovascular diseases (CVDs), which now account for about onethird
of all deaths worldwide. Together with other non-communicable diseases, CVDs
have been given a more prominent place on the agendas of global health organizations,
such as the World Health Organization and the World Heart Foundation. In addition, a
communicative infrastructure exists that enables communication about cardiology on a
global scale. Several key preconditions for the emergence of this infrastructure can be distinguished:
technological innovations (both within and outside cardiology), the success
and proliferation of professional cardiac organizations, and processes of standardization.
Standardization of expert knowledge (as, for example, in clinical practice guidelines)
seems to be of particular significance for the emergence of a global community of cardiac
professionals. Using the syndrome of heart failure as an example, we show how standardization
relates to the two other factors outlined and how empirical studies of medical specialties
can be used to advance our thinking about globalization and global knowledge
diffusion (not only of biomedicine).
Our research draws on two sources of data: clinical practice guidelines and expert interviews.
Observations at the ESC World congress, discussions with our interdisciplinary
team, and additional literature from the cardiological field helped contextualize this data.

Bettina Mahlert, University of Innsbruck
Global inequality and development: New perspectives for empirical globalization research
My presentation starts from two observations: First, the value of resources depends on
context. Therefore, in order to make statements about global inequality, trans-contextual
evaluation criteria are needed that apply to two or more contexts. Second, the notion of
‘development’ is a well-established category for observing global inequalities (i.e. inequalities
within the world population). What is striking, in the literal sense, ‘development’ is
not a category for making statements about advantage of some over others and thus about
inequality. Rather, it is a temporal category that refers to valued processes of change. I
take this peculiarity as an invitation to explore whether and how we might use (other)
theoretical concepts that refer to processes when doing research on global or transnational
inequalities. In doing so, my focus is on whether and how these concepts might be
adapted to different contexts, so that we can apply them on different analytical levels (micro/
meso/macro, local/regional/national/global….) as well as across space and time.
Thus, ‘development’ might be considered to be a process of ‘upward mobility’ that countries
undergo within an overall international structure of inequality. While ‘mobility’ is
well established as a process category in inequality research, I will explore the fruitfulness
of three less widespread concepts: First, the notion of career; second, the notion of what
might be called ‘fiduciary relationships’, such as between parents and children or professionals
and clients; third, the notion of (re-)valuation. When discussing these three concepts
by using exemplary examples, I will distill some tentative strategies for applying a
given concept to strikingly different contexts, which might be considered a key competence
of, or for, empirical globalization research.

Ludger Pries, Ruhr-University of Bochum
Transnational forced migration: between global and local approaches
Forced migration is growing in volume, even faster than overall international migration.
It is mostly studied either in global numbers and general mechanisms (like in reports of
international organizations) or in local conditions and the fate of affected persons (like
refugees stuck in camps in Greece or Africa). In this paper forced migration is analyzed in
its transnational entanglements and dynamics. The causes and contexts, the traits and
trajectories, as well as the effects and outcomes only can be analyzed in transnational
frames. Taking the example of two routes of forced migration – from Middle East to Turkey
and from Central America to Mexico – a life-course based mixed-methods approach is
presented. It combines the analysis of trajectories of forced migration as sequences of
events and of biographical narrations as subjective (re)constructions of experienced life.

 

Sigrid Quack, University of Duisburg-Essen
National Prerogative over Global Cooperation? Reflections on the Role of Health Experts in the Covid-19 Pandemic
Engaging with the literature on global epistemic communities the paper provides evidence
that during the Covid-19 Pandemic globally networked epidemiologists and public
health experts were presented publicly as "national consultants" and also presented
themselves primarily as national experts. The underlying global and transnational networks
tend to remain invisible to the public. The paper discusses implications for policy
debates: Does this positioning of the experts contribute to a prerogative of national over
international policy perspectives? What can research do to make these invisible networks
more visible and to strengthen global policy initiatives?

Parvati Raghuram, The Open University
Information Technology, gender and globalization: researching a global(ising) industry
In this paper I explore the IT industry as a fundamental global(ising) industry at the heart
of which is mobility. I look at three forms of mobility – the mobility of IT as a gendered
formation, the mobility of IT workers and the mobility of best practice as three spotlights
that highlight the empirical situatedness, the tractions and tensions of globalisation and
finally what these mean for theorising the global.

Gilberto Rescher, University of Hamburg
The theoretical relevance of socially minoritized groups in processes of globalization
Though over the last decades debates on processes of globalization and the relation between
the global and the local have led to a broad variety of approaches, the (social) position
and experiences of socially minoritized groups have often been overlooked or
simply been assumed to be similar to those of the supposed majority. Examples for this
can be found in the Americas in misconceptions concerning the case of migrants belonging
to indigenous groups or those being categorized as afrodescendientes (persons belonging
to the minorities attributed to be of African descent). Several studies show that such
groups are confronted with manifold social boundaries, often even more relevant than
national borders, and corresponding multidimensional (or intersectional) discrimination,
but also have other ways to use their agency on a day to day basis to cope with such constellations
and to actively enhance and to benefit upon processes connecting the global
and the local. However this kind of research seems to be more like an academic niche and
is rarely considered in general theories on migration, transnationality, globalization and
the like. The same applies to other fields like for example research on political systems,
democratization etc. It is important to notice that such constellations are far from being
exceptions, but are just frequently overlooked mainly due to a research perspective unconsciously
based on stereotypical assumptions. In fact in the aforementioned case of indigenous
migrants these are often overlooked as on the one hand they are often supposed
to be a kind of isolated in their communities and thus not considered to be able or “sufficiently
modern” to migrate and in the places of arrival they are on the other hand frequently
subsumed under a national category or even more homogenizing concepts like
the one of Latinos or Hispanics in the USA. In the end due to stereotypical views their
agency is not seen and in a similar manner their forms of organization or of political interaction
are often ignored as they do not fit to mainstream assumptions and to widespread
ideas of formality. However this case provides clues that such groups can even be
seen as a kind of ideal transnational migrants first due to a familiarity to cope with situations
in which they are constantly othered and confronted with prejudices, secondly a
corresponding ability to adapt to social settings with logics that defer from their own and
thirdly a stronger social cohesion resulting from broad experiences of discrimination.
Hence approaches that have been developed with the aim of grasping and understanding
the perspectives of concerned social actors and the related knowledge dynamics and
therefore tracing interactions and transfers across entanglements connecting localities
like translocality, interface analysis (Norman Long), perspectives on life-worlds and
knowledge systems (Alfred Schütz and Peter Berger/Thomas Luckmann), systems of nonknowledge
(Gudrun Lachenmann) and social remittances (Peggy Levitt) could be combined
with approaches focusing specifically on the multidimensional experiences of such
groups and in the end the agency of social actors belonging to minoritized groups. Such
approaches can be seen in the case of Lynn Stephen´s concept of transborder communities/
lifes, theoretizations of coloniality (of power) by Aníbal Quijano among others, related
to Pablo González Casanova´s idea of internal colonialism and Immanuel Wallerstein
´s world system theory, and in general in decolonial approaches like those put forward
by Silvia Rivera Cusicanqui, Ramón Grosfoguel and others. Concerning the political
dimension also concepts like Luis Tapia’s subsuelo político (political bedrock) or James
Scott´s classical works can be useful to analytically include spaces and arenas that are frequently
not formally recognized as being of relevance.
Taking empirical cases of indigenous migration, of its political implications in spheres not
considered to be “political” and as lacking formality, and of knowledge transfers in such
settings, I am aiming at the elaboration of a more comprehensive approach taking into
consideration the afore mentioned theoretical approaches. This can be a way to facilitate
the inclusion of the specific significance of diversity, difference and social inequality in
globalization and in global entaglements often related to persisting coloniality and leading
to experiences mostly different from those of other groups. Thus emphasizing the
relevance of invisibilized groups and of informal ties and settings in empirical research
and analyses to enhance the building of meso-level theories concerning such settings.
 

Jannik Schritt and Jan-Peter Voß, TU Berlin
Appropriation, colonization, commensuration: Three modes of translation in the circulation of deliberative mini-publics as a democratic innovation
The concept of translation has made a remarkable career supplanting the concept of diffusion
in studying the travel of ideas and the spreading of innovations. It is better able to
capture the challenges of transferring cultural forms across contexts. As such it underpins
empirical studies of globalization paying attention to local specifics, interweaving and hybridization,
broken circulations, and the precariousness of translocal relations, rather
than assuming a continuous convergence of cultural forms. Based on three case studies
we differentiate three modes of translation: appropriation, colonization, and commensuration.
Each of them describes a specific pattern of connection between locally embedded
practices. We develop these three modes with the help of empirical case studies of how a
specific model of public participation called “deliberative mini-publics” is transferred as
a “democratic innovation”. Our studies show that only selected elements (humans, texts,
artefacts) are transferred. Packaged into abstract models they need to be re-embedded at
any location where they are to become effective. The study of a transfer from Germany to
Japan shows how the model is modified to fit the local context of reception (appropriation).
The study of a transfer from Stanford to Skopje shows how the local context is modified
to reproduce the functions of the model (colonization). And the study of a transfer
from Oregon to Sion shows how abstract categories serve to construct embedded elements
in both localities as functionally equivalent (commensuration). In each case, however,
all three modes are relevant and play together in different ways. For analyzing translocal
circulations and the constitution of global assemblages they should therefore not be
played out against each other, neither conceptually nor normatively, but be kept as elements
of an extended analytics.

Stefan Timmermans, University of California, L.A.
The Cultural Authority of Health
In his Pulitzer-award winning account of the U.S. medical profession’s ascent, Paul Starr
drew a distinction between the “social authority” of physicians and the “cultural authority”
of medicine—between doctors’ capacity to direct others’ behavior, and the ability of
medical institutions and discourses to shape meanings of illness, health, wellness, and
treatment. Subsequently, scholars have reflected on the social-structural transformations
challenging physicians’ social authority, but neglected shifts in cultural authority. Focusing
on the U.S., I explore a proliferation and diversification of cultural authority, reflecting
a partial movement from the domain of medicine into new terrains of health. This shift is
apparent in the resurgence of alternative healing, the advent of new forms of self-care and
self-monitoring, the rise of health social movements, and the spread of health information
online. I underline the need for a cross-national perspective to understand how the mechanisms
and dynamics of cultural authority shape contests to speak in the name of health.
 

Justyna Aniceta Turkowska, University of Edinburgh
Reordering of Space and References: Geological Surveys in Ghana in the 1950-1960s
The late 1950s-early 1960s witnessed a great increase of geological export to the Global
South. Geologists and geographers were requested and trained worldwide. British, Russian,
Polish, Yugoslavian and American experts, to name just a few, rushed to Ghana, Nigeria
or Tanzania creating a situation in which thousands of international geological experts
had been working for governments and/or private investors in the newly independent
sub-Saharan countries. Most of the experts, whether American or Polish geologists,
were already well-experienced and part of the international geological community that
both in their projects and in their culture of knowledge has been transcending borders.
Yet, the geological projects conducted in the Global South followed often contradictory,
(purely) economic-nationalising goals and thus overlap in a conflictual way. The political
interests of the respective project donors, reinforced by the conflicts of the Cold War, only
complicated the already tense situation. This paper will focus on the geological (re-)mapping
of Ghana in the 1950-the 1960s that was undertaken by a set of different geological
surveys representing among others Russian, Polish and American backgrounds and interests.
By following the different surveys teams, it will show how the geological theoretical
and praxeological exchange looked like, and how it was put into practice in a multi-cultural
working environment. It will thus examine how the globally conceived but locally
situated new spatialisation and field-based redrawing of the portable knowledge of the
experts reshaped the local, transnational and global epistemic context and the (new)
transnational space of globalised expertise.
 

Anja Weiß und Ilka Sommer, University of Duisburg-Essen
Clinical practice around the world: a transnationally comparative approach with data from Ankara, Beijing, Groningen and Würzburg
Research on micro- and meso-level globalization processes tends to focus on exceptional
topics where globalizing processes are clearly at work. As the majority of the world’s population
is living a quite immobile life it actually seems unlikely that everyday transactions
are globalizing.
The research presented here focuses on everyday transactions, namely professional practice
in medicine, as a test case for micro- and meso-level globalization. Since physicians
cater to lay clients who are often old, ill, uneducated or marginalized otherwise, we expect
doctor-patient-interaction to be location-specific. Since medicine is based on scientific
knowledge produced in globalized networks and since both doctors and patients increasingly
travel, the field of health could also be globalized.
Our study constructs a quasi-experimental observational setting in which doctor-patient
interaction is observed in four strategically chosen university hospitals (Ankara, Turkey;
Beijing, PRChina; Groningen, the Netherlands; Würzburg, Germany). The sample offers
maximized contrast with respect to socio-cultural context, health system, working language,
and language of education. It is standardized by focusing on well-endowed university
hospitals, and a well-known “standard” cardiological illness that is enacted by a simulated
patient—a trained actor performing the role of a patient. Physicians themselves
are however practicing professionals, i.e. they differ in level of expertise and training and
even though they know that the situation is enacted, they can hardly avoid use of the repertoire
of routine practice that they employ when treating real patients.
This design will enable us to identify similarities and differences in observed interaction
routines, diagnoses and treatment options. The paper presents a comparison of two maximally
contrasting cases with the goal to identify meaningful dimensions of comparison.
As the analysis is progressing further and including more cases, we expect to explain some
of the observed differences and to thus assess the relative merits of various globalization
theories. With this purpose in mind, the empirical findings will be embedded in a discussion
of theoretical approaches such as pragmatism, “glocalization/vernacularization” or
“local universality”.

Tobias Werron, University of Bielefeld
Identifying „enablers“ of world society: A sociological approach to the study of globalization
Given the complexity, multiplicity and simultaneity of globalization processes, attempts
to explain globalization in causal terms are bound to fail. But what can we do instead? My
talk proposes to look for what Gabriel Abend recently described as “enablers” or “enabling
relationships”: structures, processes and events that make other social phenomena possible.
Rather than about causes and probabilities we can now talk about conditions-ofpossibility
of globalization: prerequisites that have to come together to make globalization
processes possible in the first place. The talk starts with some general reflections on
this heuristic move. The second part introduces a distinction between two types of “enablers”
of globalization: (1) global connections based on direct interaction and direct relationships
(“networking”) and (2) global meaning based on discursive observation, comparison
and evaluation (“imagining”). In the final part, I draw on my research experiences
of recent years – on topics such as competition, rankings and nationalism – to show that
the second type of enablers provides globalization scholars with a particularly promising
path for future research.