Carl is a medical sociologist with additional interests in implementation science and health services research. His research is framed by two basic questions:
- How do professionals and patients interact, and how are these interactions shaped by clinical knowledge, technique and technology in practice?
- How are new knowledge, techniques and technologies made workable and implemented in health care organizations?
Beginning with studies of professional-patient interaction, knowledge and practice, his work has shifted over time to explore help-seeking and referral behaviours and the translation of evidence into practice in the management of long-term and life-limiting conditions. In parallel he has also studied the development and implementation of innovations in health technology and organization. These studies have led to the development of a novel conceptual model of individual and organizational behaviour (Normalization Process Theory, with Dr Tracy Finch) which facilitates understanding of the mechanisms through which practices of care and self-care become embedded in their social contexts. Extending this work in collaboration with Professor Victor Montori (Mayo Clinic, US) and Professor Frances Mair (Glasgow University, Scotland) led first to the development of a novel methodology for clinical practice (Minimally Disruptive Medicine), and then to the development of a robust theoretical model of patient behaviour (Burden of Treatment Theory). These developments facilitate understanding of help-seeking and service utilization, and take into account the wider socio-economic environment and social or relational networks in which the patient is set.