Innovation, professional identity, and generational divides in medicine: The case of gynecologic laparoscopy in the USA.

Studies have linked the diffusion of medical innovations to a distinctive professional project. In this project, physician specialists embrace an innovation, work to advance its successes, link these successes to their core-skill definitions, and use this linkage in boundary work to promote their professional identities and expand their jurisdictions, largely by distinguishing themselves from others within their profession. Drawing from a case study examining the diffusion of laparoscopic sterilization procedures in American ob/gyn, this article suggests that a specific type of revitalization movement may serve as an unwitting catalyst for these innovation/professional projects. To promote a"new"specialist identity, this revitalization movement employs foil labeling in its boundary work that dishonors, not outsiders, but established clinicians within the specialty. This dishonoring motivates these clinicians, as a generational cohort, to embrace radical innovations and break established work patterns. Radical innovations may spread across medical fields, not so much through projects bonding professionals to a unified collective, but through reactive projects within highly specialized fields prone to fragment along generational lines.