Surgeons and the Scope: (Collection on Technology and Work)

In Surgeons and the Scope, James R. Zetka Jr. describes the impact of the video laparoscope on the work lives of contemporary surgeons. The video laparoscope allows surgeons to peer into the inner abdomen with a miniaturized camera, thereby enabling them to perform complex operations without large incisions through small ports punched into the abdominal wall. This technological innovation revolutionized surgery as we know it. Zetka blends rich interview and archival data into a compelling account of an important technological development. He shows how the new laparoscopic technology challenged surgeons to rethink their approaches to surgery, to relearn basic hand-eye coordination, to master complex machinery, and to shift from individualistic to team-based work strategies. Zetka then explains how and why general surgeons embraced this disruptive technology by examining the breakdown of the division of labor between general surgeons and gastroenterologists in response to the unintended and unanticipated outcomes of the scope technology. In Surgeons and the Scope, Zetka weaves cultural, structural, and political economic developments into a sophisticated account of technological change. By viewing the advent of laparoscopic surgery within the context of the history, culture, and ideology of medicine, Zetka provides a deeper understanding of the politics of technology, particularly its effects on job skills, occupations, and worker control.

Table of Contents:
Skill disruption in the surgical craft; Teamwork in conventional and video surgery; Dominance, competition, and negotiation within occupational divisions of labour; General surgeons' response to the early scopes; Gastroenterologists embrace the scope; State mediation and intraoccupational developments; Turf wars over the gastrointestinal tract; Technological innovation in the surgical craft; Theoretical reflections.

About the Author :
James R. Zetka Jr. is Associate Professor in the Department of Sociology at the State University of New York, Albany. He is author of Militancy, Market Dynamics, and Workplace Authority: The Struggle over Labor Process Outcomes in the U.S. Automobile Industry, 1946-1973.

Review :
"Surgeons and the Scope is the fifth volume in a Cornell University series on technology and work. The author is a sociologist who used interviews of practitioners, observations of videoscopic procedures, and archival materials to describe the interplay of forces in medicine and surgery and other factors that led to surgeons' development and control of laparoscopic surgery. The book is written as a sociological case study of the impact of technology on work and is a solid contribution to the sociology of occupations and professions. Moreover, those other than sociologists should also find it an interesting and insightful account of the development and impact of 'scope' technology."-Journal of the American Medical Association, March 24/31, 2004 "Our strength of Zetka's work is that he enhances his historical analysis of the intraoccupational competition within medicine with a workplace focus. This allows him to demonstrate the importance of location in the focus. This allows him to demonstrate the importance of location in the occupational division of labor; as a downstream occupation, surgeons were dependent on referrals to procure patients on which to work... A simultaneous workplace and historical occupational study is a daunting undertaking, and Zetka does a laudable job of combining the two. Another strength of the work is that it lies at an interesting intersection of occupations, work, and technology... Scholars interested in the diffusion of innovation would find much to like in his analysis of the cultural and structural factors involved in the adoption of the surgical scope."-Beth A. Bechky, University of California, Davis, American Journal of Sociology, vol. 110, no. 1, July 2004 "Surgeons and the Scope is a fascinating book that examines the interaction between technology adoption and the relationship across different specialty areas within the medical profession... Zetka's main objective is to contribute to the research on the organization of work and occupations by examining how processes and structure together affect intraoccupational coordination and control, and he clearly accomplishes this goal. Zetka's finding, too, though, have much to contribute on routines and capabilities... Overall, this work is laudable for its comprehensiveness, readability, and its insightful contributions to our understanding of how work is organized."-Sharon F. Matusik, University of Colorado, Boulder, Administrative Science Quarterly, March 2004 "Surgeons and the Scope is a truly unusual, distinguished book. It vividly charts the historic process by which laparoscopic technology was adopted, placing the hows and whys into the context of the history, cultures, and ideologies of medicine and surgery. Drawing on interviews, James R. Zetka Jr. provides a thoroughly satisfying, clear description of scope technologies and the skills and practices required of those who use the instrument."-Eliot Freidson, University of California, San Francisco "The assimilation of endoscopy (flexible and rigid) into general surgical practice was a transforming event of the kind that very seldom occurs. James R. Zetka Jr. describes how the different approaches toward flexible endoscopy and laparoscopy chosen by surgeons fundamentally shaped the practice of surgery today. This information is vital to the understanding of the marketplace in which surgeons practice."-John G. Hunter, M.D., Oregon Health and Science University