Biomedical subjects

A C Twaddle

Publications and source records attributed to A C Twaddle.

16 recordsLinked to original sources

PubMed1989

Swedish physicians' perspectives on work and the medical care system--V. Comparisons across specialties.

Treating medical specialties as segments, Swedish ambulatory care physicians were interviewed to identify their perspectives on work and the medical care system. Those perspectives were analyzed and compared across segments. Physician segments differed substantially in the themes they put forward. Perspectives tended to be homogeneous within segments and sharply differentiated between segments. Both positive and negative perspectives were expressed more with respect to immediate work situations than with respect to the medical care system. Child health and maternal health physicians were more likely to express satisfactions with both work and the system, while district general practitioners were more likely to note problems. It is contended that this study has identified well grounded (valid) categories for the analysis of the Swedish medical care system.

Ambulatory Care↗

PubMed1988

Swedish physicians' perspectives on work and the medical care system--III: Private practitioners on the public system.

This paper reports the results of focused interviews in 1978-1979 with Swedish physicians in private practice about the public system of medical care in Sweden. They were asked about the system as a work environment for physicians and as a system of care for patients. Respondents, who were outside the public system (although financed mainly by public mechanisms) said the public system as a place to work had advantages in its high technical quality, facilities for research and training, and the capacity to treat complicated disease; its disadvantages were said to be inefficiency, lack of communication, poor patient care, and blocked mobility for physicians without doctorates. As a system of care, its one advantage was said to be that it provided care at less out-of-pocket cost to patients; its reported disadvantages were poor quality care and a tendency to be overly comprehensive. These perspectives are discussed with respect to their structural and historical contexts.

Ambulatory Care↗

PubMed1987

Swedish physicians' perspectives on work and the medical care system--II: The cases of child and maternal health physicians.

This paper reports the results of focused interviews with child health and maternal health physicians in the public ambulatory care sector of a large Swedish city to describe (1) the organization of their work activities, (2) their perspectives on their work, and (3) their perspectives on the medical care system. Child health physicians (who were attached to a major teaching hospital) practiced in child health clinics for preschoolers and school health clinics. Each physician covered several such settings. Maternal health physicians were attached to local hospitals and practiced full time in maternal health centers. Child health physicians described their work in terms of preventive care, patient care, integration of ambulatory and hospital services, and technological sophistication; they described the system in terms of quality of care, quality of diagnosis and treatment, adequacy of resources, and distribution of services. Maternal health physicians described work in terms of a biophysical orientation, practice independence, relations with hospitals and other specialists, and dependence on nurses; they described the system in terms of technological sophistication, ambulatory and hospital care, and problems of other specialties. Both were more positive about both work and the system than were district general practitioners, and some interpretation is offered.

Ambulatory Care↗

PubMed1986

Swedish physicians' perspectives on work and the medical care system: the case of district general practitioners.

Interviews with district general practitioners in a large Swedish city in 1978-1979 solicited their perspectives on the frustrations and satisfactions they felt in their work, and on the successes and failures of the Swedish medical care system. With respect to work, four themes emerged: medical routine, patient centered care, overwork and isolation. Five themes emerged with respect to the system: financing, relationships with hospitals and specialists, involvement in political decision making, the size of districts and care centers. These themes are discussed with relation to the influence of the social situation of practice to the influence of the social situation of practice and the conditions for physician satisfaction.

Ambulatory Care↗

PubMed1986

Power and change: the case of the Swedish Commission of Inquiry on Health and Sickness Care.

This paper reviews the work of the Swedish Commission of Inquiry formed in 1975 to propose a new law governing medical care. Based on interviews with commission members, the interests and goals of participating groups are identified. These are compared to the outcome as published in the final report in 1980. Consumer interests gained few of their objectives, while physicians gained almost all of theirs. For others, results were mixed.

Community Health Services↗

PubMed1982