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The (non) use of prioritisation protocols by surgeons

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journal contribution
posted on 23.07.2020 by Kevin Dew, M Stubbe, L Macdonald, A Dowell, E Plumridge
Priority setting and rationing is a dominant feature of contemporary health policy. In New Zealand, clinical priority assessment criteria (CPAC) tools have been developed to make access to elective surgery more equitable and efficient. Research was undertaken to identify how surgeons used these tools in the consultation. Forty-seven consultations with 15 different surgeons have to date been video- and audio-recorded. There were no instances where CPAC tools were explicitly used in the consultation. Drawing on the methodology of conversation analysis and the concept of news delivery as developed by Maynard, this paper argues that the delivery of diagnoses and treatment plans can usefully be seen in part as the delivery of bad or good news. Using three case studies to illustrate the argument, it is suggested that the interactional work required in the delivery of such news challenges the ability of clinicians to use protocols such as CPAC. The analysis sheds light on important consultation processes that need to be more carefully considered when designing interventions to influence clinician behaviour. In order to influence the behaviour of clinicians to achieve policy goals, greater attention needs to be paid to the interactional demands of the consultation process. © 2010 The Authors. Journal compilation © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

History

Preferred citation

Dew, K., Stubbe, M., Macdonald, L., Dowell, A. & Plumridge, E. (2010). The (non) use of prioritisation protocols by surgeons. Sociology of Health and Illness, 32(4), 545-562. https://doi.org/10.1111/j.1467-9566.2009.01229.x

Journal title

Sociology of Health and Illness

Volume

32

Issue

4

Publication date

01/01/2010

Pagination

545-562

Publisher

Wiley

Publication status

Published

Contribution type

Article

Online publication date

12/02/2010

ISSN

0141-9889

eISSN

1467-9566

Language

en

Exports