The physician as a neoliberal subject – A qualitative study within a private-public mix setting

• Published in: Social science & medicine (1982) Vol. 259; p. 113152
• Main Authors: Rasooly, Alon, Davidovitch, Nadav, Filc, Dani
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2020
• Subjects: Delivery of Health Care; Humans; Israel; Neoliberalism; Physician perspective; Physician's Role; Physicians; Private-public mix; Qualitative Research; Qualitative research; Israel; Neoliberalism; Physician perspective; Private-public mix
• ISSN: 0277-9536; 1873-5347; 1873-5347
• DOI: 10.1016/j.socscimed.2020.113152

Research on neoliberalism in health care has insufficiently explored the intermediary role of physicians in neoliberal subjectification. This paper studies the construct of the physician as a neoliberal subject in the Israeli health care system, using qualitative data from in-depth interviews with 21 medical specialists. We interviewed physicians from specialties in which private practice is both less common (infectious disease and intensive care) and more common (orthopedics, cardiology, and cardiothoracic surgery). Our analysis focused on two key issues: the physician's role in society and the value placed on health care. We found a spectrum of views. At one end, some perceived themselves as entrepreneurs, managing themselves both as an enterprise and a product, and perceived health care as a commodity. At the opposite end, we found a professional ethos that considered the physician as a public servant, and health care as a human right. Both views were in constant tension with neoliberal subjectivity. Further research should investigate the association between institutional belonging, whether public or private, and the internalization of the main characteristics of the neoliberal worldview. •Neoliberalization influences how physicians perceive their role, practice & patients.•Perceived roles go from serving the common good to an entrepreneur of oneself.•The Physician-Entrepreneur chooses healthier patients to avert risk.•Physicians' professional ethos is in tension with neo-liberal subjectivity.•Researchers should examine how subjectification relates with institutional context.