Work

Institutional phronesis: theorizing how US primary care clinicians navigate competing incommensurate logics of efficiency, care, and market in clinical practice

Year: 2026

Type: article

Abstract: In the highly privatized United States primary care environment, physicians must attend to incommensurate logics of quality care. That is, they must attempt to holistically care for patients within a system that has been described as highly commodified and bureaucratically violent. I introduce the concept of institutional phronesis as a key component of the professional skills required to navigate this complex organizational environment. The article uses ethnographic insights garnered through 18 months at a rural medical center to demonstrate how primary care physicians experience disparate logics and seek to provide high-quality care through institutional phronesis in this setting. I close with recommendations for how institutional phronesis might be incorporated in physician professional development and continuing education.

Source: Advances in Health Sciences Education

DOI: 10.1007/s10459-026-10576-2

Author: Chloe L. Warpinski

Institution: University of Florida

Language: English

Topic: Primary Care and Health Outcomes

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

Open Access status: hybrid

Estimated APC paid: $3,290

Funders: National Science Foundation, National Institute on Minority Health and Health Disparities