Medical community of Tobolsk governorate in 18th - early 20th centuries: from the modality of idea to the modality of realization

The article under consideration is meant to represent the process of the development of the regional medical community as being continuous and dynamic, from the formation of the structure, meant to provide service to people, to the establishment of the pro fessional associations that became means of mobility, coordination, publicity and support for the socially-minded people. To achieve the above mentioned purpose we will deal with the following objectives: 1) to consider the dynamics of the size and distribution of the medical staff in Tobolsk Governorate, 2) to describe the evolution of the professional communicative practices and connections, 3) to explore the disposition of the person of a doctor in the worldview of the provincial community. The research has been carried out within the methodological frameworks of the modernization theory. It has applied modern sociological definitions of the concept “community” within the semantic field of the antonymous notions “unreal/real”. This approach allows avoiding discontinuity of the research discourse and makes it possible to study the regional professional community as an integral social cultural entity with several qualitatively different stages-modalities of the development. The research relies on a wide range of published and archival documents. The materials of the Medical board, the regional statistics data, periodicals and the volunteer associations' documents have been used. As the result of the research, the author has come to the following conclusions. The formation of the medical community presupposes three stages of modality: starting with the modality of idea (or hypothetic - “theoretical” community) through the stage of underachieved reflexion (the modality of potential - “imaginary” community), up to the modality of realization and phenomenological completion (the modality of reality - “real” community). At the stage of idea (i.e. “theoretical” stage) the community is characterized by a small number of medical staff, absolute predominance of instrumental relations and significant distance between the doctor and the provincial community. At the stage of potential modality (“imaginary” community) the number of medical professionals grows, the network of internal communication expands, the first professional associations emerge, the reproduction of health care specialists begins, and the doctor becomes a common character of the social urban landscape. At the stage of realization (“real” community) the number of medical staff significantly increases, the network of health care facilities develops throughout the Governorate, communication intensifies. Thus, the medical community turns into the functioning collective body, comprised of the most active professional forces that are capable of self-organization, setting up claims, decision-making and taking measures. The system of private medical practitioners develops. Doctors take active part in different social events, they become an integral part of the provincial community. The incorporation of the character of a doctor into the provincial community was not an equable process.

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