Medicine and the Professions

The sociology of the professions is also of particular relevance to the study of credibility and expertise, since professionalism, as Andrew Abbott notes, is precisely "the main way of institutionalizing expertise in industrialized countries."^[108] A crucial focus of my study is the relations between professional groups and lay clients, and I take seriously Foucault's suggestion that this is a pivotal arena of struggle in modern societies—that power is manifested in the ability of professionals to label, classify, and condemn, as well as in the capacity of clients to resist the imposition of such meanings.^[109] However, my analysis also seeks to avoid reifying the categories "professional" and "layperson" as if they were invariant or monolithic entities. I therefore analyze tendencies toward professionalization within social movements that engage with expert knowledge.

Furthermore, my analysis assumes that the interests of the various researchers and doctors who figure in the AIDS controversies are shaped by their specific relations to organizations, institutions, and social groups. For example, I analyze the fundamental differences in interest and orientation between biomedical researchers, whose primary commitment is to science, and practicing physicians, whose immediate commitment is to patients. As Eliot Freidson notes, medicine is an "impure" social form—a profession with a lay clientele, coexisting with a scientific community of peers.^[110] In debates over how to interpret research findings, practitioners of the healing "arts" who are in direct contact with patients may produce different readings than researchers who are invested in a conception of biomedicine as

"science"—and, of course, some individuals occupy both roles simultaneously.^[111] In analyzing such debates, this study seeks to reinforce the emerging links between studies of medical practice that have been central to the sociology of medicine and analyses of knowledge production that have been developed by the sociology of science.^[112]