International Encyclopedia of Public Health: Second Edition

International Encyclopedia of Public Health: Second Edition1, 2, 3, 4, 5, 6, & 7447

Health care systems and the people: a five-nation study in the European Union.

The results of an exploratory five-nation survey of 2,239 adults interviewed on the telephone indicate general satisfaction with the health care system and less satisfaction with common welfare. In particular German respondents reported minor problems in their experiences with doctors with regard to communication and timing. Concerning health policy, French and Spanish respondents favoured more interventionist medicine, while Germans in particular preferred medicine as care. The public responsibility for care and the shifting of responsibility for future financial needs to employers and the public reveal a tendency that has been called corrupt. Overall, when evaluations and attitudes concerning health care and related policies were controlled for demographic factors, they were not particularly determined by social stratification, which indicates that the health system functions well in providing comprehensive care and securing the identity and integration of society. However, value orientations as a reflection of culture and the respective nationalities are strong determinants of health care systems. National identity confirms at the same time the validity of the comparative approach and the use of multivariate analyses

The clinical encounter and the problem of context

The encounter between professional and patient is one of the basic units of analysis in the field of ‘medical’ sociology. From the very beginnings of the sociological investigation of medical practice it has been conceived as a dyadic encounter, defined by asymmetries of power, the negotiation of rational and authoritative scientific knowledge, and private, proximal, relations. This article argues for a more dynamic theoretical vision of the clinical encounter: one that shifts attention away from a Parsonian ‘paradigm’ of professional–patient interaction towards a perspective that incorporates the systemic changes that late modernity brings to medicine.The clinical encounter is no longer the dyadic system envisaged by Parsons, and his theoretical perspective–which has played an important part in framing sociological accounts of the practice of medicine – now needs to be reframed in relation to the organizing impulses of contemporary corporate professional practic