Creating health care consumers: The negotiation of un/official payments, power and trust in Russian maternity care

Темкина, Анна; Rivkin‐Fish, Michele

doi:10.1057/s41285-019-00110-3

Cited by 20 publications

(31 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The path of the healthcare transformation started with the Soviet collapse in 1990s, when the key trends of the reforms were the liberalization of material provision (in particular, cuts in state's expenditure on healthcare). Transformation in this period also launched the process of patients' consumerization, in particular, resulting in transformation of providers' power, authority, and domination in their relationships with patients [39]. As a result, clinics and doctors became dependent on volatile state funding and patients' pocket money.…”

Section: Institutional Arrangement and Change Of Maternity Care In Rumentioning

confidence: 99%

“…In particular, consumerization of patients' behavior transforms providers' authority and domination, and maternity care remains a field of power struggle for decision-making and ability to influence care provision and organization. But at the same time, Russian childbirth services still remain a limited means of empowerment for patients and providers [39], while the state, through the increasing control and bureaucratized machinery of regulation, remains a dominant actor.…”

Section: Institutional Arrangement and Change Of Maternity Care In Rumentioning

confidence: 99%

“…And so how could one live on these wages, when you need to feed the family" (field notes, conversation with a doctor). This is a hidden topic which is ambivalently evaluated in medical community (about informal payments see [39]).…”

Section: "Big Brother Is Watching You"mentioning

confidence: 99%

“…Patients are trying to get more control over the situation, evaluate doctors and hospitals, describe their experience, write down comments on the Internet. Patients are becoming more exacting as consumers [39].…”

Section: "An Extremist Patient"mentioning

confidence: 99%

See 3 more Smart Citations

Multiple Vulnerabilities in Medical Settings: Invisible Suffering of Doctors

2019

Self Cite

View full text Add to dashboard Cite

While there is a substantive amount of literature on vulnerability of different kinds of patients in different settings, medical professionals are usually considered as the ones who possess power and gain a privileged position. In this paper, we aim to demonstrate that in a certain context physicians—a social group which is usually referred to as “powerful”—consider themselves vulnerable, and this positioning may influence patients in turn. This perspective highlights the complexity of interactions within medical organizations and contributes to the studies of sensitive topics and vulnerable groups. We conceptualize vulnerability of doctors and discuss what can be problematic in powerful doctors’ position. We describe some features of the post-Soviet context of Russian healthcare system and maternity care, both of which can be conceptualized as a hybrid of legacy of Soviet paternalism and new neoliberal reforms, managerialism and marketization. Empirical research is based on the ethnographic evidence from the study of a Russian perinatal center. In this article, we explore specific “existential” and “moral” vulnerabilities of medical professionals who routinely have to cope with multiple challenges, such as complicated clinical tasks, rigid control of different state bodies and emotional responses of suffering patients. We argue that there is a bond between the vulnerability of doctors and that of patients, whose position becomes more problematic as professionals become more vulnerable. At the end, we discuss methodological and theoretical implications of our research.

show abstract

Section: Institutional Arrangement and Change Of Maternity Care In Rumentioning

confidence: 99%

Section: Institutional Arrangement and Change Of Maternity Care In Rumentioning

confidence: 99%

Section: "Big Brother Is Watching You"mentioning

confidence: 99%

Section: "An Extremist Patient"mentioning

confidence: 99%

See 2 more Smart Citations

Multiple Vulnerabilities in Medical Settings: Invisible Suffering of Doctors

2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Russian health-care system has often been characterised by the multiplicity of informal relations between patients and health-care workers (Temkina and Rivkin-Fish 2019;Zvonareva et al 2018). These relationships can be both financial and based on friendship and favours.…”

Section: Amr Antibiotics and Russian Health Carementioning

confidence: 99%