Sarah Van den Bogaert

In the land of pharma : a qualitative analysis of the reputational discourse of the pharmaceutical industry

The pharmaceutical industry has been battling a negative reputation and has been confronted with accusations such as putting profits before patients and manipulating clinical trial results. In this study, we focus on how pharmaceutical companies address what we define as the Bad Pharma discourse. Drawing on interviews, press releases, corporate documentation and ethnographic fieldwork, we analyse the main themes that are used by the Belgian pharmaceutical industry to construct its reputational discourse, and we focus on how this discourse is shaped by the Bad Pharma discourse. Our results illustrate that on the one hand, the industry contests the Bad Pharma discourse by generating an alternative discourse. On the other hand, they also partly embrace and reframe this Bad Pharma discourse. This way, current societal debates are entextualised in the reputational discourses of the pharmaceutical industry.

(Dis)entangling medicine and media: a qualitative analysis of the relationship between the fields of healthcare and journalism

ABSTRACT Previous research has illustrated that journalists play an active role in the production of health news. The current study explores the relationship between the fields of healthcare and journalism from a healthcare perspective. Drawing on Bourdieu’s theory of fields and Gieryn’s concept of boundary-work, this study employed elite interviewing to analyse how the relations between these two fields were reflected and negotiated in the discourses of Belgian health-policy stakeholders. Our analysis illustrated that health-policy stakeholders perceived medicine and the news media as two different cultures and, therefore, discursively positioned news media actors as outsiders. Additionally, we showed that the nature of the relationship between health-policy stakeholders and the news media was linked to health-policy stakeholders’ position within the healthcare field. Through this analysis, we illustrate the value of using the concept of boundary-work as an analytical instrument to study the relationships between fields.

The silver lining of greying: Ageing discourses and positioning of ageing persons in the field of social health insurance

Contemporary ageing discourses and policies perceive being active as the key to a good later life and thereby focus on individual responsibility and self-care. Drawing on website articles and press releases of Belgian sickness fund agencies, this study analyses the ageing discourses and positioning of ageing persons of these organisations. A discourse analysis was performed using positioning theory to analyse how sickness fund agencies discursively construct the ageing process and position ageing persons, and to investigate how these positioning acts are related to sickness fund agencies’ roles as social insurer, social movement, social entrepreneur and private insurer. Our results reveal three storylines on ageing; ageing as a medical problem, ageing as a new stage in life and ageing as a natural life process. These storylines are applied to construct ageing and position ageing persons in different ways. Depending on their role, sickness fund agencies take on a different position drawing on these different storylines. We also show how these storylines reproduce the moral framework on how to age well and thereby disempower ageing persons. Our results underline the importance of multidimensional perspectives on ageing.

Training COPC and Leadership Development at Ghent University, Belgium

In this chapter a dual approach has been undertaken: on the one hand student participation as a strategy for training leadership and becoming change agents is documented, on the other hand, 12 years of experience is described with the development of an interprofessional community diagnosis exercise in the undergraduate medical curriculum at Ghent University. This, the Community Oriented Primary Care exercise is an attempt to integrate in the third year of the undergraduate training program knowledge, skills and attitudes that are needed for the training of a ‘Five-Star Doctor’ (Boelen, 1997). This exercise is part of the integrated curriculum at Ghent University, based on patient-centredness, student-centredness, community orientation and problem orientation, and evidence-based practice. Therefore, at several points the curriculum offers experiences with interprofessional work in the community, especially in primary care.

Student participation: To the benefit of both the student and the faculty

Students who actively participate in the evaluation of their undergraduate medical curriculum become important stakeholders in decisions related to the design of the school′s curriculum. Research and reports on student participation in curriculum change are scarce, and not much is known about how students personally benefit. We describe the structure and activities of engaging students in designing and improving the curriculum at the Faculty of Medicine and Health Sciences of Ghent University (Belgium). We present an example of a major curriculum change led by students, and we assess the perceptions of the students on how engagement in student curriculum committees strengthened their leadership skills. We encourage students at other schools to become active participants in the curriculum design and improvement processes of their institutions as a way to improve medical education.