School of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel.
School of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Soc Sci Med. 2020 Aug;259:113152. doi: 10.1016/j.socscimed.2020.113152. Epub 2020 Jun 23.
Research on neoliberalism in health care has insufficiently explored the intermediary role of physicians in neoliberal subjectification. This paper studies the construct of the physician as a neoliberal subject in the Israeli health care system, using qualitative data from in-depth interviews with 21 medical specialists. We interviewed physicians from specialties in which private practice is both less common (infectious disease and intensive care) and more common (orthopedics, cardiology, and cardiothoracic surgery). Our analysis focused on two key issues: the physician's role in society and the value placed on health care. We found a spectrum of views. At one end, some perceived themselves as entrepreneurs, managing themselves both as an enterprise and a product, and perceived health care as a commodity. At the opposite end, we found a professional ethos that considered the physician as a public servant, and health care as a human right. Both views were in constant tension with neoliberal subjectivity. Further research should investigate the association between institutional belonging, whether public or private, and the internalization of the main characteristics of the neoliberal worldview.
医疗保健中的新自由主义研究尚未充分探讨医生在新自由主义主体化过程中的中介作用。本文使用来自对 21 名医学专家的深入访谈的定性数据，研究了以色列医疗保健系统中医生作为新自由主义主体的建构。我们采访了私人执业较少（传染病和重症监护）和更为常见（骨科、心脏病学和心胸外科）的专业医生。我们的分析集中在两个关键问题上：医生在社会中的角色和对医疗保健的重视。我们发现了一系列观点。一方面，一些人将自己视为企业家，将自己既作为企业又作为产品进行管理，并将医疗保健视为商品。另一方面，我们发现了一种职业道德，认为医生是公务员，而医疗保健是一项人权。这两种观点都与新自由主义的主体性不断产生紧张关系。进一步的研究应该调查机构归属（无论是公共的还是私人的）与新自由主义世界观主要特征的内化之间的关联。
