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Evidence-based medicine and physicians' institutional agency in Russian clinical settings.
- Source :
-
Critical Public Health . Sep2023, Vol. 33 Issue 4, p409-420. 12p. - Publication Year :
- 2023
-
Abstract
- In 1990s' Russia, a wave of internationalization brought an evidence-based medical paradigm to Russian healthcare. Whilst there has been considerable critical commentary on the consequences of adopting this paradigm for medical decision-making, much of this relates to specific contexts in Europe, north America and Australasia, with little research addressing post-Soviet clinical practice. Drawing on semi-structured qualitative interviews with Russian physicians, this article explores the entanglements between the introduction of evidence-based medicine (EBM) in the country and the transformation of post-socialist medical professionalism. I single out physicians' efforts to reconcile the EBM paradigm with organizational constraints as indicative of professionals' ground-level agency. I define the following components of such agency: (1) selective application of guidelines and use of foreign clinical recommendations; (2) establishing local professional solidarity; (3) developing relationships based on personalized trust with the patients. The study employs two sets of data (gathered in 2018 and in 2020) to trace the EBM-related agency of medical professionals both before and during COVID-19 pandemic. By offering analytical insights from post-socialist healthcare, where doctors' discretion has historically been limited by excessive state control, the article contributes to academic debate on medical professionals' autonomy and agency in the era of EBM-related standardization. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MEDICAL quality control
*RESEARCH methodology
*PHYSICIAN-patient relations
*EVIDENCE-based medicine
*INTERVIEWING
*QUALITATIVE research
*MEDICAL protocols
*RESEARCH funding
*PHYSICIANS
*STATISTICAL sampling
*THEMATIC analysis
*DECISION making in clinical medicine
*OUTPATIENT services in hospitals
*TRUST
Subjects
Details
- Language :
- English
- ISSN :
- 09581596
- Volume :
- 33
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Critical Public Health
- Publication Type :
- Academic Journal
- Accession number :
- 168582883
- Full Text :
- https://doi.org/10.1080/09581596.2023.2180608