Lancaster Medical School, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK.
Department of Sociology, Lancaster University, Bowland North, Lancaster, UK.
Sociol Health Illn. 2022 Jul;44(7):1077-1093. doi: 10.1111/1467-9566.13480. Epub 2022 May 18.
Doctors are typically portrayed as active agents in their work lives. However, this paper argues that this construction of agency ignores the effects of the healthcare structures that constrain choice, which in turn affects population health outcomes. Medical training pathways, regional boundaries, and rationalisation all have a long-lasting impact on the provision of healthcare. Using a mobilities lens to examine the movement of doctors, this paper examines how the expectation of movement built into training programmes perpetuates unequal access to healthcare. Long waiting times, poor care quality and lack of preventative care all perpetuate health inequalities; as one of the socio-economic determinants, access to healthcare affects health outcomes.
医生通常被描绘为工作生活中的积极行动者。然而,本文认为,这种对能动性的构建忽视了限制选择的医疗保健结构的影响,而这反过来又影响了人口的健康结果。医学培训途径、区域界限和合理化都对医疗保健的提供产生持久的影响。本文利用流动的视角来考察医生的流动,研究培训计划中内置的流动预期如何使医疗保健的获得不平等永久化。长时间的等待时间、较差的护理质量和缺乏预防保健都使健康不平等永久化;作为社会经济决定因素之一,获得医疗保健会影响健康结果。