Модели поведения врачей в ситуации назначения платных услуг

ИНТЕРакция. ИНТЕРвью. ИНТЕРпретация. 2021. Т. 13. № 1. С. 40–62.

Андреева Е. А.

The Russian healthcare system provides a set of free and paid diagnostic and therapeutic services. Although, when prescribing additional paid services, a specific doctor is provided with the situation of choice. The doctor is faced with a set of ethical and professional motivators,  one  of which is  paid services  as  a  source of  additional  medical  income.  What do  doctors do in this situation, what strategies do they choose and what motivates their decision? Conducted and analyzed in-depth interviews (18 interviews, Tver, 2018) with doctors of different specialities revealed several patterns of doctor’s behavior when prescribing paid services. The data analyzed in the tactics of grounded theory allowed the author to build several models of doctor’s behavior, where such choices are associated with certain system of  professional  and  personal  values.  The  described  models  are  conventionally  named  by  author: “Making  money”, “Polypragmasia”, “Collegiality”, “Man-System”, “One  and  a half  rates”, “Out  of the system”, “Avoidance”.The constructed models of behavior of doctors show that the appointment of additional  optional  procedures  is  associated  not  only  with  the  doctor’s  desire  to  earn  money, but also can be explained by a more complex combination of reasons, working conditions, formal and informal social norms, as well as the basic values of the doctors themselves.

Keywords: платные медицинские услуги, basic values, doctor patient relationship, assignment of optional paid services, paid services, doctors’ values, взаимоотношщения врач-пациент, ценности врачей, государственное здравоохранение

Publication based on the results of: Analysis of adaptation of various socio-economic and demographic groups to the pandemic consequences in the context of new social policy measures (2021)