The clinical work of secretaries: Exploring the intersection of administrative and clinical work in the diagnosing process
Diagnostic work is often defined by the skill of clinicians whereas the contributions of non-clinicians, for example secretaries, tend to fade into the background. The secretaries are deeply involved in diagnostic work through the eligible administration of patients in the collaborative electronic information systems. This study explores the secretaries’ role in diagnostic work, focusing specifically on the context of diagnosing cancer. It identifies four key activities of secretaries that are essential for diagnosing patients: examining the patient’s condition, interpreting the clinical information, monitoring the follow-up, and further informing the patient’s trajectory. We argue that secretaries’ role is positioned at the intersection of clinical and administrative practices and not limited to support of articulation work of clinicians and administrative work. Secretaries also carry out activities that fall under the core definition of clinical work. This clinical dimension of the secretaries’ work, we argue, should be embedded in the design of collaborative systems to support the diagnosing process.