Cette recherche analyse la mise en œuvre des SIRIC (Sites de recherche integres sur le cancer) co... more Cette recherche analyse la mise en œuvre des SIRIC (Sites de recherche integres sur le cancer) concus comme une mesure-cle du Plan Cancer 2009-2013. Dans la mesure ou celle-ci est ancree dans des configurations locales singulieres et malgre un certain nombre de traits communs (liees notamment aux thematiques scientifiques dominantes au plan international), les resultats de cette recherche soulignent l’heterogeneite de la forme prise par les Siric et des usages qu’en font les acteurs. La recherche s’interesse aussi au pilotage des Siric et montre qu’il depend fortement des relations entretenues entre les equipes de direction des Siric et un certain nombre d’acteurs, dont les representants scientifiques locaux qui beneficient d’une reputation incontestable et les directions des etablissements. On note que, face aux contraintes, les directions des Siric privilegient la creation d’entites organisationnelles additionnelles ou le recrutement de nouveaux personnels specialises en recherche...
This course introduces graduate students to core theoretical underpinnings in current institution... more This course introduces graduate students to core theoretical underpinnings in current institutional analyses of organizations, industries and organizational fields. Our aim is to cover the major theoretical contributions to institutional analyses of organizations (old and new institutionalism, role of institutional entrepreneurs, competing logics etc.) and to examine recent advances in theory and research that extend these approaches in interesting ways. During the course, you will develop a solid understanding of different perspectives in organizational institutionalism and how they conceptualize the relationship between organizations and their institutional environment.
A la lecture de la presse et de travaux de sciences sociales, dans les reportages televises ou ra... more A la lecture de la presse et de travaux de sciences sociales, dans les reportages televises ou radiophoniques, la concurrence semble s’intensifier chaque jour un peu plus dans les secteurs d’activite qui la connaissaient deja, et s’inviter dans de nouveaux secteurs comme la sante, l’education ou la justice qui en etaient jusque-la preserves. Dans la sphere dite marchande, la liberalisation des echanges, la globalisation de l’economie et les imperatifs de rentabilite, entre autres facteurs, sont reputes exacerber la concurrence entre agents sur le marche du travail, entre entreprises, produits ou services. [Premieres lignes du chapitre]
HAL (Le Centre pour la Communication Scientifique Directe), Feb 1, 2021
This Special Issue (SI) on “Organizing precision oncology” features a number of articles initiall... more This Special Issue (SI) on “Organizing precision oncology” features a number of articles initially presented at an International Workshop on “Organizational and epistemic innovation in precision cancer medicine” that took place in November 2018 in Paris. The Workshop was convened to mark the conclusion of a project supported by the French National Cancer Institute (INCa), entitled “Targets and trials: A sociological investigation of personalized cancer medicine in action (PERSONA).” The papers included in the SI investigate the implementation of precision oncology by focusing on the nexus between organizing and experimenting. The SI thus includes contributions that interface Science & Technology Studies (STS) and Organization Studies to analyze how clinicians and researchers deploy genomic platforms and the socio-technical and organizational arrangements that act as a condition of possibility for the performance of this new kind of clinical medicine
This Special Issue (SI) on “Organizing precision oncology” features a number of articles initiall... more This Special Issue (SI) on “Organizing precision oncology” features a number of articles initially presented at an International Workshop on “Organizational and epistemic innovation in precision cancer medicine” that took place in November 2018 in Paris. The Workshop was convened to mark the conclusion of a project supported by the French National Cancer Institute (INCa), entitled “Targets and trials: A sociological investigation of personalized cancer medicine in action (PERSONA).” The papers included in the SI have been revised and updated to reflect developments in the two years since the workshop was held. As hinted by the title of the Workshop, they investigate the implementation of precision oncology by focusing on the nexus between organizing and experimenting. The SI thus includes contributions that interface Science & Technology Studies (STS) and Organization Studies to analyze how clinicians and researchers deploy genomic platforms (Cambrosio et al. 2018) and the socio-technical and organizational arrangements that act as a condition of possibility for the performance of this new kind of clinical medicine. According to the 2020 Annual Report of the Personalized Medicine Coalition (PMC; http://www.personalizedmedicinecoalition.org) – an “international, multistakeholder, non-profit organization” for promoting the eponymous domain – the number of individualized medicines on the US market grew by 116% during the previous four years, and more than 75,000 genetic tests are available. In oncology, 61% of clinical trials now incorporate biomarkers compared to just 18% in 2000. In 2020, the FDA approved 27 precision oncology drugs, including 10 new molecular entities (NMEs) and 17 new indications of previously approved drugs, a 35% increase compared to the previous year (Staff Reporter 2021). These data point to a shift from the traditional focus on a tumor’s tissue of origin to the genetic basis of the disease, as highlighted, for instance, by the New Genetics and Society, 2021 Vol. 40, No. 1, 1–6, https://doi.org/10.1080/14636778.2021.1883501
Medical practices in oncology are expected to be more and more multidisciplinary, yet few article... more Medical practices in oncology are expected to be more and more multidisciplinary, yet few articles studied how this may be concretely applied. This article is describing the functioning of a multidisciplinary specialized committee in a rare tumor. 219 medical cases during 26 meetings between 09/04/2003 and 14/02/2004 had been studied. Discussions had been observed, described and studied qualitatively and quantitatively. At the time of a national plan has been launched to impose obligatory the consultation of such committees before any treatment strategy, two lessons can be drawn from this case study. On the one hand, it shows that a multidisciplinary committee may be an organizational tool facilitating the emergence of collective decisions, since it may facilitate the formulation and the discussion of alternative options (72 cases out of 219). More generally, to take treatment decisions, members of the committee exchange arguments that deal mostly with clinical and psychological con...
This paper aims to contribute to the literature on the role of entrepreneurs in social and instit... more This paper aims to contribute to the literature on the role of entrepreneurs in social and institutional change. Having described the types of “intermediary-entrepreneurs” and “translator-entrepreneurs” which have previously been identified in sociology, the authors propose a third type, that of the “boundary-entrepreneur” defined as an actor at the border of closed universes, a boundary-object and a border-guard. The study of the creation of a French programme for the prevention of childhood obesity helps to identify some of its promoters as boundary-entrepreneurs. The paper shows that these promoters have extended their self-presentations to fit into a world of multiple institutional boundaries and conflicts. By adopting the symmetrical point of view of the programme’s partners, the authors show that their recruitment was based on a series of projections and selective appropriations about the identity of the promoters of the programme and the actions that were developed.
Cette recherche analyse la mise en œuvre des SIRIC (Sites de recherche integres sur le cancer) co... more Cette recherche analyse la mise en œuvre des SIRIC (Sites de recherche integres sur le cancer) concus comme une mesure-cle du Plan Cancer 2009-2013. Dans la mesure ou celle-ci est ancree dans des configurations locales singulieres et malgre un certain nombre de traits communs (liees notamment aux thematiques scientifiques dominantes au plan international), les resultats de cette recherche soulignent l’heterogeneite de la forme prise par les Siric et des usages qu’en font les acteurs. La recherche s’interesse aussi au pilotage des Siric et montre qu’il depend fortement des relations entretenues entre les equipes de direction des Siric et un certain nombre d’acteurs, dont les representants scientifiques locaux qui beneficient d’une reputation incontestable et les directions des etablissements. On note que, face aux contraintes, les directions des Siric privilegient la creation d’entites organisationnelles additionnelles ou le recrutement de nouveaux personnels specialises en recherche...
This course introduces graduate students to core theoretical underpinnings in current institution... more This course introduces graduate students to core theoretical underpinnings in current institutional analyses of organizations, industries and organizational fields. Our aim is to cover the major theoretical contributions to institutional analyses of organizations (old and new institutionalism, role of institutional entrepreneurs, competing logics etc.) and to examine recent advances in theory and research that extend these approaches in interesting ways. During the course, you will develop a solid understanding of different perspectives in organizational institutionalism and how they conceptualize the relationship between organizations and their institutional environment.
A la lecture de la presse et de travaux de sciences sociales, dans les reportages televises ou ra... more A la lecture de la presse et de travaux de sciences sociales, dans les reportages televises ou radiophoniques, la concurrence semble s’intensifier chaque jour un peu plus dans les secteurs d’activite qui la connaissaient deja, et s’inviter dans de nouveaux secteurs comme la sante, l’education ou la justice qui en etaient jusque-la preserves. Dans la sphere dite marchande, la liberalisation des echanges, la globalisation de l’economie et les imperatifs de rentabilite, entre autres facteurs, sont reputes exacerber la concurrence entre agents sur le marche du travail, entre entreprises, produits ou services. [Premieres lignes du chapitre]
HAL (Le Centre pour la Communication Scientifique Directe), Feb 1, 2021
This Special Issue (SI) on “Organizing precision oncology” features a number of articles initiall... more This Special Issue (SI) on “Organizing precision oncology” features a number of articles initially presented at an International Workshop on “Organizational and epistemic innovation in precision cancer medicine” that took place in November 2018 in Paris. The Workshop was convened to mark the conclusion of a project supported by the French National Cancer Institute (INCa), entitled “Targets and trials: A sociological investigation of personalized cancer medicine in action (PERSONA).” The papers included in the SI investigate the implementation of precision oncology by focusing on the nexus between organizing and experimenting. The SI thus includes contributions that interface Science & Technology Studies (STS) and Organization Studies to analyze how clinicians and researchers deploy genomic platforms and the socio-technical and organizational arrangements that act as a condition of possibility for the performance of this new kind of clinical medicine
This Special Issue (SI) on “Organizing precision oncology” features a number of articles initiall... more This Special Issue (SI) on “Organizing precision oncology” features a number of articles initially presented at an International Workshop on “Organizational and epistemic innovation in precision cancer medicine” that took place in November 2018 in Paris. The Workshop was convened to mark the conclusion of a project supported by the French National Cancer Institute (INCa), entitled “Targets and trials: A sociological investigation of personalized cancer medicine in action (PERSONA).” The papers included in the SI have been revised and updated to reflect developments in the two years since the workshop was held. As hinted by the title of the Workshop, they investigate the implementation of precision oncology by focusing on the nexus between organizing and experimenting. The SI thus includes contributions that interface Science & Technology Studies (STS) and Organization Studies to analyze how clinicians and researchers deploy genomic platforms (Cambrosio et al. 2018) and the socio-technical and organizational arrangements that act as a condition of possibility for the performance of this new kind of clinical medicine. According to the 2020 Annual Report of the Personalized Medicine Coalition (PMC; http://www.personalizedmedicinecoalition.org) – an “international, multistakeholder, non-profit organization” for promoting the eponymous domain – the number of individualized medicines on the US market grew by 116% during the previous four years, and more than 75,000 genetic tests are available. In oncology, 61% of clinical trials now incorporate biomarkers compared to just 18% in 2000. In 2020, the FDA approved 27 precision oncology drugs, including 10 new molecular entities (NMEs) and 17 new indications of previously approved drugs, a 35% increase compared to the previous year (Staff Reporter 2021). These data point to a shift from the traditional focus on a tumor’s tissue of origin to the genetic basis of the disease, as highlighted, for instance, by the New Genetics and Society, 2021 Vol. 40, No. 1, 1–6, https://doi.org/10.1080/14636778.2021.1883501
Medical practices in oncology are expected to be more and more multidisciplinary, yet few article... more Medical practices in oncology are expected to be more and more multidisciplinary, yet few articles studied how this may be concretely applied. This article is describing the functioning of a multidisciplinary specialized committee in a rare tumor. 219 medical cases during 26 meetings between 09/04/2003 and 14/02/2004 had been studied. Discussions had been observed, described and studied qualitatively and quantitatively. At the time of a national plan has been launched to impose obligatory the consultation of such committees before any treatment strategy, two lessons can be drawn from this case study. On the one hand, it shows that a multidisciplinary committee may be an organizational tool facilitating the emergence of collective decisions, since it may facilitate the formulation and the discussion of alternative options (72 cases out of 219). More generally, to take treatment decisions, members of the committee exchange arguments that deal mostly with clinical and psychological con...
This paper aims to contribute to the literature on the role of entrepreneurs in social and instit... more This paper aims to contribute to the literature on the role of entrepreneurs in social and institutional change. Having described the types of “intermediary-entrepreneurs” and “translator-entrepreneurs” which have previously been identified in sociology, the authors propose a third type, that of the “boundary-entrepreneur” defined as an actor at the border of closed universes, a boundary-object and a border-guard. The study of the creation of a French programme for the prevention of childhood obesity helps to identify some of its promoters as boundary-entrepreneurs. The paper shows that these promoters have extended their self-presentations to fit into a world of multiple institutional boundaries and conflicts. By adopting the symmetrical point of view of the programme’s partners, the authors show that their recruitment was based on a series of projections and selective appropriations about the identity of the promoters of the programme and the actions that were developed.
(the summary in French is below).
Since 1945, the provision of health care in France has been gr... more (the summary in French is below).
Since 1945, the provision of health care in France has been grounded in a social conception promoting universalism and equality. The French health-care system is based on compulsory social insurance funded by social contributions, co-administered by workers' and employers' organisations under State control and driven by highly redistributive financial transfers. This system is described frequently as the French model. In this paper, the first in The Lancet's Series on France, we challenge conventional wisdom about health care in France. First, we focus on policy and institutional transformations that have affected deeply the governance of health care over past decades. We argue that the health system rests on a diversity of institutions, policy mechanisms, and health actors, while its governance has been marked by the reinforcement of national regulation under the aegis of the State. Second, we suggest the redistributive mechanisms of the health insurance system are impeded by social inequalities in health, which remain major hindrances to achieving objectives of justice and solidarity associated with the conception of health care in France.
Depuis 1945, les politiques de santé en France s’appuient sur une conception sociale s’inspirant de deux principes : l’universalisme et l’égalité. Le système de santé français repose en effet sur un système de sécurité sociale obligatoire et fortement redistributif, financé par les contributions sociales et co-administré par les organisations patronales et salariales, sous le contrôle de l’Etat. Ce système est fréquemment désigné comme le « modèle français ». Dans cet article, le premier du numéro spécial du Lancet sur la France, nous remettons en question quelques idées reçues sur l’accès à la santé en France. Dans un premier temps, nous ouvrons la réflexion sur les transformations politiques et institutionnelles qui ont affecté la gouvernance de la santé au cours des dernières décennies. Nous montrons d’une part que le système de santé, loin d’être uniforme, repose sur une diversité d’institutions, mécanismes et acteurs des politiques de santé, d’autre part que la gouvernance de la santé a été marquée par une tendance au renforcement du rôle régulateur de l’Etat. Dans un second temps, nous suggérons que les mécanismes de redistribution du système d’assurance maladie sont bien actifs, mais que leur efficacité reste entravée par les inégalités sociales de santé, lesquelles constituent des obstacles majeurs à la réalisation des objectifs de justice et de solidarité qui sont au cœur de la conception sociale de la santé en France.
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Papers by Patrick Castel
Since 1945, the provision of health care in France has been grounded in a social conception promoting universalism and equality. The French health-care system is based on compulsory social insurance funded by social contributions, co-administered by workers' and employers' organisations under State control and driven by highly redistributive financial transfers. This system is described frequently as the French model. In this paper, the first in The Lancet's Series on France, we challenge conventional wisdom about health care in France. First, we focus on policy and institutional transformations that have affected deeply the governance of health care over past decades. We argue that the health system rests on a diversity of institutions, policy mechanisms, and health actors, while its governance has been marked by the reinforcement of national regulation under the aegis of the State. Second, we suggest the redistributive mechanisms of the health insurance system are impeded by social inequalities in health, which remain major hindrances to achieving objectives of justice and solidarity associated with the conception of health care in France.
Depuis 1945, les politiques de santé en France s’appuient sur une conception sociale s’inspirant de deux principes : l’universalisme et l’égalité. Le système de santé français repose en effet sur un système de sécurité sociale obligatoire et fortement redistributif, financé par les contributions sociales et co-administré par les organisations patronales et salariales, sous le contrôle de l’Etat. Ce système est fréquemment désigné comme le « modèle français ». Dans cet article, le premier du numéro spécial du Lancet sur la France, nous remettons en question quelques idées reçues sur l’accès à la santé en France. Dans un premier temps, nous ouvrons la réflexion sur les transformations politiques et institutionnelles qui ont affecté la gouvernance de la santé au cours des dernières décennies. Nous montrons d’une part que le système de santé, loin d’être uniforme, repose sur une diversité d’institutions, mécanismes et acteurs des politiques de santé, d’autre part que la gouvernance de la santé a été marquée par une tendance au renforcement du rôle régulateur de l’Etat. Dans un second temps, nous suggérons que les mécanismes de redistribution du système d’assurance maladie sont bien actifs, mais que leur efficacité reste entravée par les inégalités sociales de santé, lesquelles constituent des obstacles majeurs à la réalisation des objectifs de justice et de solidarité qui sont au cœur de la conception sociale de la santé en France.