ABSTRACT
This book brings together a collection of empirical case studies that highlight a wide spectrum of important, if inadequately recognised, features of advances in medicine, namely: the persistent uncertainty that permeates dealing with human disease; the importance of failure as a starting point for successful innovations; the role of the institutional context in opening up or hampering new ideas and methods; the persistence of inefficient practices; the leadership of key individuals and the supporting role of emergent professional networks; the reconfiguration of scientific boundaries; and the role of conflicts within and across professions. Taken together, the chapters that make up this volume show that, while there is no unique pathway to successful medical innovation, recurring and distinctive features can be observed across different areas of clinical practice. Common to all the case studies is that the efforts to innovate were a response to perceived weaknesses in prevailing patient care. The cases also highlight that not all problems have solutions within the prevailing state of knowledge, and that workable solutions often prove to be of very differing efficacy. The key question is therefore why medical practice develops so unevenly across and within areas of disease and over time, and how this relates to the underlying conditions of innovation across areas of practice.
