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      Empathy and Efficiency in Healthcare at Times of Austerity

      research-article
      1 , 2 ,
      Health Care Analysis
      Springer US
      Empathy, Efficiency, Austerity, Healthcare, Professionalism

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          Abstract

          Efficiency is an important value for all publicly funded healthcare systems. Limited resources need to be used prudently and wisely in order to ensure best possible outcomes and waste avoidance. Since 2010, the drive for efficiency, in the UK, has acquired a new impetus, as the country embarked on an ‘age of austerity’ purportedly to balance its books and reduce national deficit. Although the NHS did not suffer any direct budget cuts, the austerity policies imposed on the welfare system, including social and mental healthcare, have had a direct and detrimental impact on the healthcare service. This paper draws from a qualitative study conducted in three A&E Departments in England to explore the effects of austerity policies on the everyday experiences of doctors and nurses working in Emergency Departments. It discusses the operationalisation of efficiency in A&E, in a climate of austerity, and its effects on the experiences and practices of healthcare professionals. It uses the empirical data as a springboard to highlight the role of structures and regulations, in this case targets and protocols, in how core healthcare ethical values, such as empathy, are exercised in practice. It provides an analysis of the normative role structures and regulations can play on the perception and practice of professional duties and obligations in healthcare.

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          Explaining Compassion Organizing

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            Disease and illness. Distinctions between professional and popular ideas of sickness.

            The dysfunctional consequences of the Cartesian dichotomy have been enhanced by the power of biomedical technology. Technical virtuosity reifies the mechanical model and widens the gap between what patients seek and doctors provide. Patients suffer "illnesses"; doctors diagnose and treat "diseases". Illnesses are experiences of discontinuities in states of being and perceived role performances. Diseases, in the scientific paradigm of modern medicine, are abnormalities in the function and/or structure of body organs and systems. Traditional healers also redefine illness as disease: because they share symbols and metaphors consonant with lay beliefs, their healing rituals are more responsive to the psychosocial context of illness. Psychiatric disorders offer an illuminating perspective on the basic medical dilemma. The paradigms for psychiatric practice include multiple and ostensibly contradictory models: organic, psychodynamic, behavioural and social. This mélange of concepts stems from the fact that the fundamental manifestations of psychosis are disordered behaviours. The psychotic patient remains a person; his self-concept and relationships with others are central to the therapeutic encounter, whatever pharmacological adjuncts are employed. The same truths hold for all patients. The social matrix determines when and how the patient seeks what kind of help, his "compliance" with the recommended regimen and, to a significant extent, the functional outcome. When physicians dismiss illness because ascertainable "disease" is absent, they fail to meet their socially assigned responsibility. It is essential to reintegrate "scientific" and "social" concepts of disease and illness as a basis for a functional system of medical research and care.
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              Compassion: The Basic Social Emotion

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                Author and article information

                Contributors
                0044 1865 287895 , angeliki.kerasidou@ethox.ox.ac.uk
                Journal
                Health Care Anal
                Health Care Anal
                Health Care Analysis
                Springer US (New York )
                1065-3058
                1573-3394
                31 May 2019
                31 May 2019
                2019
                : 27
                : 3
                : 171-184
                Affiliations
                [1 ]ISNI 0000 0004 1936 8948, GRID grid.4991.5, The Ethox Centre, Nuffield Department of Population Health, , University of Oxford, ; Oxford, England UK
                [2 ]ISNI 0000 0004 1936 8948, GRID grid.4991.5, The Wellcome Trust Centre for Ethics and Humanities, Nuffield Department of Population Health, , University of Oxford, ; Oxford, England UK
                Author information
                http://orcid.org/0000-0001-9344-3297
                Article
                373
                10.1007/s10728-019-00373-x
                6667398
                31152291
                4c270fd6-a194-4022-82d2-67fa9291cf9b
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: 201552/Z/16/Z
                Award ID: 203132/Z/16/Z
                Award Recipient :
                Categories
                Original Article
                Custom metadata
                © Springer Science+Business Media, LLC, part of Springer Nature 2019

                Medicine
                empathy,efficiency,austerity,healthcare,professionalism
                Medicine
                empathy, efficiency, austerity, healthcare, professionalism

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