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Federal Center of Theoretical and Applied Sociology of the Russian Academy of Sciences
The article looks at the way the patient’s status influences the healthcare practices of doctors from various fields, representing healthcare facilities at various levels. This study continues the series of empiric research papers that was first launched at the Independent Institute of Social Policy and then continued at the Higher School of Economics, under the supervision of S.V. Shishkin. The series is dedicated to analyzing the Russian doctors’ motivation and the informal rules that govern their behavior. We have collected the necessary data via interviews with doctors and healthcare system managers. This research reveals that modern Russian doctors modify their professional behavior depending on whether the patient’s social status is high or low, and have different approaches to rich and poor patients, as well as to family members and colleagues. Our analysis has allowed us to arrive at the conclusion that, in terms of their perception of status, doctors can be divided in two vastly unequal groups. The first group, which is larger in size, includes doctors that claim to advocate for patient equality and to believe that everyone deserves medical aid. They are mostly doctors that were trained during Russia’s Soviet past. For them, acknowledging the importance of financial or social status would mean denying the moral and ethical norms that their teachers passed on to them. The second group includes doctors that recognize the importance of money in the modern world and point out that having none can have a significant impact on the quality of healthcare services. It would hardly be appropriate to believe that doctors are a solid and uniform social group and all have the same moral and ethics code. The fact that this code may vary reflects that corporate ethics spread chaotically within the healthcare community rather than being systemically implemented. Nevertheless, the opposite (i.e. the complete loss of corporate ethics as a governing compass for doctors) is not true either. Some doctors hold on to their conservative preconceptions, while others do attempt to find new ethical reference points but are too hesitant to spread their views among the whole community. This makes it difficult to consolidate the healthcare community on the basis of shared morals and ethics.
patients’ status, doctor’s conduct scenarios, rich and poor patients, family or corporate ties, doctor’s attention