In the kingdom of expertness, the profane is king. Carriers of medical innovations

Abstract

In an attempt at understanding the embeddedness of heterogeneous actors in the emerging field of telemedicine, I identify actors who possess medical knowledge (classified as "experts"), as well as other actors (classified as "profanes") who control technology (which is another form of knowledge). Currently, both sets of actors are merged and are involved in the creation of what may be seen as a social construction of medical innovation. This dichotomy between profanes and experts is analysed by following several recent French telemedicine programmes. In this paper, I identify the actors, typologies and trajectories of these programmes. The analysis then proceeds to determine how the localization of innovation influences its evolution and provides the identity of a heterogeneous actor network. In conclusion, I present trajectories between medical knowledge and technical know-how within a broader social dimension, where arenas are built beyond the initial users and where past conventions challenge the affinity between the profanes' status and the experts' value.