A 3: Tutor submission – essay plan

A 3: Tutor submission – essay plan

Morris Gallagher 513748

Photography 3: Contextual Studies A3

Challenging medical dominance in visual culture: a discourse analysis

Word count (Plan = 497; Extracts from essay = 878)

List of Illustrations

Figure 1: BBC News Special: Coronavirus Update 15/02/2021 (2021) Directed by BBC. 15/02/2021; 32.06mins. At: https://www.bbc.co.uk/iplayer/episode/m000ssfg/bbc-news-special-coronavirus-update-15022021?page=4 (Accessed  16/03/2021).

Figure 2: BBC News Special: Coronavirus Update 15/02/2021 (2021) Directed by BBC. 15/02/2021; 38.05mins. At: https://www.bbc.co.uk/iplayer/episode/m000ssfg/bbc-news-special-coronavirus-update-15022021?page=4 (Accessed  16/03/2021).

PLAN for 5,000-word essay

Chapter 1 (750 words)


1.1 Introduction

  • Intention: How and why do medical institutions dominate and control images of health care? Where is the photographic challenge to medical hegemony?
  • Definition medical dominance
  • Literature review medical dominance (300). 
  • Hypotheses 1: Are there three pivotal periods of changes in medical dominance of doctors? (From A2)
  • Hypotheses 2: Are there alternatives to stereotypes of doctors as heroes and villains? (From A2)

1.2 Methodology

  • Discourse analysis with semiotic analysis of images (Rose, 2016: chapters 8 and 9).

1.2.1 Literature

  • Worked example, 18-19C changes in medical culture (90).

1.2.2 Theoretical frameworks (220)

  • Foucault – textual and contextual discourse analysis of power relations within medical institutions  (Foucault, 1996). 
  • Sociology of medical culture and power (Lupton, 2003)
  • Hall – meaning and representation in medical visual culture (Hall et al., 2013)
  • Barthes – signs, meanings and mythology (Barthes, 1977, 1957). 
  • Bourdieu – cultural capital and habitus in doctor identity formation (Huang, 2019)

Chapter 2 (750 words)


  • Analysis of two images – Institutions employ motifs, graphs and language to emphasise knowledge/power. 
  • My content analysis
  • Mythologies of ‘war’ and ‘greatness,’ ideological system and practices
  • ‘Rules’ that counter resistance.

Chapter 3 (1,500 words)


3.1 Introduction (177)

  • Not always dominant; Asclepius, Hippocrates, Christianity then unpopular quacks
  • What practices produce medical dominance – how and why
  • Hypothesis 

3.2 Fildes and ‘The Doctor’ medical portrait (600)

  • Pivotal point of change
  • Semiotic analysis of portrait. 
  • Advent of medical certification, patient power and expectation, changing ideologies, medical schools, ‘end’ of patronage. 
  • Mass audience distribution and acceptance.

3.3 Mass media and audiences

3.3.1 The Country Doctor (200)

  • Image analysis
  • Extension of ‘family’ and ‘caring’ doctor…mass audiences, on every coffee table

3.3.2 TV medical dramas (200)

  • Experiments with doctor representation…pedlars of biomedicine
  • …conservatism and reinforcement of medical dominance.

3.3.3 Contemporary presentations (200)

  • The visible and invisible doctor 
  • Coronavirus doctors
  • Media and medical control.

3.4 Habitus and cultural capital in training doctors (250)

  • Lupton – identity formation, cultural phases, institutions
  • Armstrong – power relations in medical encounters in the everyday practices of habitus, (Lupton, 2003; Armstrong, 2018)

3.5 Reviewing hypothesis

Chapter 4 (1,500 words)


  • Theoretical frameworks – Foucault, Flusser (Flusser, 2016)

4.1 Benetton poster – man dying of AIDS (400)

  • Semiotic analysis of Toscani’s poster: ‘shock’ to medical perceptions of illness and the power of biomedicine.

4.2 Photographic practice about the body (200)

  • Challenges to medical gaze – Jo Spence. 
  • Medical MRI imaging – discipline and authority – Cartwright (Cartwright, 1995)

4.3 Currie’s “The Three doctors” (250)

  • A challenge to painterly conventions about doctor representation or reinforcing medical hegemony?  

4.4 Dr Jekyll and Mr Hyde (300)

  • Stereotyping – heroes and villains – Shipman and Whitty. The hidden ‘ordinary (third) man’ of this story.
  • Response to hypothesis 2

4.5 My body of work (400)

  • Previous practice
  • Displaying an ‘inner’ life – the distressed doctor – outside the stereotype – intertextuality of work
  • Semiotic discussion of two created works

Chapter 5 (500 words)




Sample texts (2)

1. From the beginning of Chapter 1 (114 of words)

“…ruling groups…attempt to fashion the whole of society according to their own world view, value system, sensibility and ideology. So right is this world view for the ruling groups that they make it appear (as it does to them) as ‘natural’ and ‘inevitable’ – and for everyone – and as far as they succeed, they establish their hegemony. (Dyer, 1977;30)


This paper examines how and why medical institutions dominate and control images of health care and investigates photographic and other challenges to this medical hegemony.

Starr defines medical dominance as “the power of doctors to control the actions of other through commands and cultural authority deriving from the value accorded to medical knowledge” (Starr, 1982)…

2. The whole of Chapter 2 (746 words)

Medical dominance in the ‘Coronavirus Press Briefing.’

Do institutions control people’s responses to medical images and knowledge?  Figures 1 and 2 are images from a televised ‘Coronavirus Press Briefing’ (BBC News Special: Coronovirus Update 15/02/2021, 2021). This was shown after the 3rd wave peak of cases when 15 million people had received their first vaccine.

Figure 1: Screensave of BBC News Special: Coronovirus Update 15/02/2021, 2021; 32.05 mins

Figure 2: Screensave of BBC News Special: Coronovirus Update 15/02/2021, 2021; 38.05 mins

The denotive aspects of this video are that three people enter a room to stand behind wooden lecterns which have placards on them which say, “Stay home – Protect the NHS – Save lives.” Screen texts inform us that this is the ‘Prime Minister,’ flanked by the ‘Chief Medical Adviser, Dr Chris Whitty,’ and ‘Chief Executive Officer of the NHS,’ Sir Simon Stevens. The Downing Street logo fills a TV screen to the left of the room and a suited man is signing speech to the right of the image. The room is wood-panelled, with elaborate light holders, a bright patterned carpet in front of the speakers and unfurled Union Jack flags visible in an anteroom (Fig 1).

The conative aspects are of these scenes are that three institutions orchestrate a display. The first is a broadcasting company that answers to government and “reflects the balance of opinion amongst elites” (Mills and Sinclair, 2017). Next, the institute of government is represented by its prime politician and two senior medical doctors, who also represent medical institutions and are answerable to politicians. This is a display of governmental, media and medical power; power within power, within power. This is a lecture about managing covid-19; most of us accept the reading that they have the knowledge and authority to do this, because ‘that is their job’ or ‘they know what’s best.’ Dr Whitty employs graphical images to re-enforce their knowledge credentials. 

My content analysis participant’s speech reveals two main themes; “the vaccine rollout is going well’ and ‘there is still a threat as infection rates are very high.’ The commonest word used after “vaccine” was “high or very high;” Prof Chris Whitty used the latter word five times. The Prime Minister’s celebrates “powering past the target’s we have set,” and helping “vulnerable people” (the third most used phrase) and being cautious for the future. The context of this briefing is that it pre-dates a “road map” for reducing constraints amidst pressure from conservative politicians and other critics to release social restraints; they are the target audience for this briefing. 

Several myths are referenced in this tableau of signs and signifiers. The first is  ‘war briefings’ from the 1940’s; the union flag, the panelled room at “No 10”, reference past war successes. This analogy is inferred yet understood by viewers; “The meaning is already complete, it postulates a kind of knowledge, a past, a memory, a comparative order of facts, ideas and decisions (Barthes, 1957). The Prime Minister ‘wrapped’ in the Union Jack references past glories of when Britain was ‘Great,’ (Johnson, 2014). In this context his analogy reflects the success of British technology to produce a successful vaccine. These ideological systems, whose meanings and messages are orchestrated and founded on culture, knowledge and history, are read consciously or unconsciously by viewers.

One might argue that medical and political dominance in Covid-19 policy is a ‘preferred’ response; it is a natural, ideological and hegemonic. Doctors gift  patients the power of a clinical gaze where patients accept their scientific knowledge. The problem is that not everyone shares this ideological view, which leaves little room for disagreement, challenge or counter narratives, such as those about delayed lockdown and increased coronavirus deaths. We see this in the ‘Q and A’ session of this briefing, where press and  public are given an opportunity ‘challenge’ this strategic dominance. The leadership trio control what is sayable and ignore or neutralises disagreements, while superficially giving the appearance of public accountability. 

In his later writings Foucault comments that systems of power are usually strategic and always include plans to nullify dissent, “every relationship of power tends, both through its intrinsic course of development and when frontally encountering resistances, to become a winning strategy” (Foucault, 1994).

To summarise, in this Covid-19 briefing we see a regime of representation with visual and textual practices about medical knowledge of how to manage a pandemic, rules about talking about the pandemic and counter narratives, and practices for with dealing with people – its polities. In this essay we will explore how we have arrived at these polities and means of representation and examine challenges to medical dominance in visual culture.


Key References

Armstrong, M. (2018) Goodbye whistleblowers: the new truth-tellers in the age of resistance. http://www.mantlethought.org/philosophy/goodbye-whistleblowers-new-truth-tellers-age-resistance.

Barthes, R. (1957) Mythologies. (2012th ed.) New York: Hill and Wang (Originally published Editions du Seuill).

Barthes, R. (1977) ‘The rhetoric of the image.’ In: Image-Music-Text. New York: Hill and Wang. At: https://faculty.georgetown.edu/irvinem/theory/Barthes-Rhetoric-of-the-image-ex.pdf (Accessed  06/11/2020).

BBC News Special: Coronavirus Update 15/02/2021 (2021) Directed by BBC. 15/02/2021. At: https://www.bbc.co.uk/iplayer/episode/m000ssfg/bbc-news-special-coronavirus-update-15022021?page=4 (Accessed  16/03/2021).

Cartwright, L. (1995) Screening the Body : Tracing Medicine’s Visual Culture. Minnesota: University of Minnesota Press.

Flusser, V. (2016) Towards a philosophy of photography. (Originally published in German in 1983) Glasgow: Bell and Bain.

Foucault, M. (1994) Power: Essential Works 1954-84: Volume Three. (s.l.): Penguin Books.

Foucault, M. (1996) The Birth of the Clinic: An Archaeology of Medical Perception. Oxford: Vintage; Reprint edition (1 May 1996).

Hall, S. et al. (2013) Representation. (Second) London: Sage.

Huang, X. (2019) ‘Understanding Bourdieu – Cultural Capital and Habitus’ In: Review of European Studies 11 p.45.

Johnson, B. (2014) Rule Britannia. At: https://www.historic-uk.com/HistoryUK/HistoryofBritain/Rule-Britannia/ (Accessed  27/04/2021).

Lupton, D. (2003) Medicine as Culture. (s.l.): Sage Publications Ltd.

Mills, T. and Sinclair, I. (2017) The BBC is neither independent or impartial: interview with Tom Mills. At: https://www.opendemocracy.net/en/ourbeeb/bbc-is-neither-independent-or-impartial-interview-with-tom-mills/ (Accessed  27/04/2021).

Rose, G. (2016) Visual Methodologies: An Introduction to the Interpretation of Visual Materials. (4th ed.) London: Sage Publications Ltd.

Starr, P. (1982) The Social Transformation of American Medicine. New York: Basic Books.