ABSTRACT
The aim of this article is to show how Jürgen Habermas' communicative action theory serves as a useful tool in analysing and interpreting empirical data on how Danish general practitioners experience defensive medicine in their everyday working life. Through six qualitative focus group interviews with a total of 28 general practitioners (14 men and 14 women), the general practitioners' understandings of and experiences with defensive medicine were unfolded and discussed. Traditionally, defensive medicine is understood as physicians' deviation from sound medical practice due to fears of liability claims or lawsuits. In this study, however, a broader understanding of defensive medicine emerged as unnecessary medical actions that are more substantiated by feelings of demands and pressures than meaningful clinical behaviour. As a first analytical step, the data are contextualized drawing on the medical sociological literature that has theorized recent changes within primary health care such as regulation, audit, standardization and consumerism. Using Habermas' theorization to further interpret the general practitioners' experiences, we argue that central areas of the general practitioners' clinical everyday work life can be seen as having become subject to the habermasian social and political processes of 'strategic action' and 'colonization'. It is furthermore shown that the general practitioners share an impulse to resist these colonizing processes, hereby pointing to a need for challenging the increasingly defensive medical culture that seems to pervade the organization of general practice today.
Subject(s)
Communication , Defensive Medicine/legislation & jurisprudence , General Practice , General Practitioners/legislation & jurisprudence , Practice Patterns, Physicians' , Primary Health Care , Aged , Denmark , Female , Focus Groups , Humans , Male , Middle Aged , Qualitative Research , SociologyABSTRACT
In order to stimulate interest in the preventive aspects of health care, the County Council in Vejle, Denmark, and the local medical officers of health jointly invited local politicians and opinion leaders from a broad spectrum of professions to discuss the theory and practice of health promotion. This article describes some of the main issues considered, including practical initiatives that have been or could be taken locally
