Protests of health care workers during the health care reform: Representation of discourse in digital media

Abstract

The article dwells on study of adaptation mechanisms implemented by medical workers in online and offline spaces in a situation of ongoing changes in institutional healthcare environment. An analysis of the discourse, elements of its rhetoric is carried out. It allows to suggest the reasons for persistence of the protest moods in professional community over the past decades. At the first stage of the study content analysis of the medical Internet portal was carried out. There were analyzed the materials of the “Profession” section for the period from 2011 to 2015. The target audience of it is medical workers. News reports about protest actions carried out by the labor collectives of Russian healthcare facilities during the period of the healthcare system reform (N=51) were studied. At the second stage, from the comments (N=2104) of the members of the forum (direct speech), a base of linguistic elements (N=35 183) was formed; a frequency analysis of the text corpus was carried out; elements of the protest discourse rhetoric were identified. In the course of the analysis, it was revealed that the protest activity of the professional community is supported by status deprivation, ignoring the needs and interests of medical workers by representatives of the dominant groups — officials and employers — and their legal insecurity. In the offline space these problems become a motive for integrating the community to overcome bureaucratic barriers and carry out collective action — holding protests. In the on-line space, in the discussion of the objective situation, the adaptive mechanism of emotionally focused coping is implemented; emotions of resentment type find expression. In general, the transformation of the institutional foundations of health care system is perceived by physicians as traumatic, threatening the stability of the professional community’s social well-being and the socio-cultural foundations of medical practice.