This study aims to identify conceptions of the body, as well as "rational" treatment
among primary care practitioners (PCPs) and emergency medicine practitioners (EMPs)
dealing with managed care plans. I conducted ethnographic study throughout 1996, and
interviewed six PCPs and four EMPs. In the course of my interviews, I discovered that
EMPs' and PCPs' perceived meaning and power in regards to treatment of their patients
has been increasingly resituated by the power of scientific discourse as utilized by
technocrats (such as consumer, provider, and insurance organizations who formulate
managed care plans).
Technocrats have developed scientific measurements to monitor physicians'
performances, quantifiably or scientifically. Technocrats conceptualize ideal treatment as
a cost effective care. They guide PCPs to supervise ideal treatment of the managed care
delivery networks, providing care without referring patients to specialists and
administrating to hospitals. Consequently, PCPs' power to pursue the newly
conceptualized ideal treatment influences other arenas of specialty, such as EMPs. On the
other hand, EMPs develop preferred treatment which is formulated through their medical
school education and clinical experiences. The preferred treatment is associated with time
because EMPs have to treat acute conditions of their patients within a limited amount of
time. However, EMPs sometimes cannot complete their preferred treatment because they
have to send their patient back to the patients' contracted PCPs in order to save health
care expenditure.
Technocrats implemented the engineering concept of quality control, and the
concept is incorporated into the principle of managed care plans, and preventive medicine.
As a result, the managed care plan networks become like production lines of large
manufacturing factories, and PCPs work as laborers to maintain the bodies of enrollees in
healthy conditions. / Graduation date: 1998
| Identifer | oai:union.ndltd.org:ORGSU/oai:ir.library.oregonstate.edu:1957/33798 |
| Date | 09 December 1997 |
| Creators | Sumii, Kensuke |
| Contributors | Rosenberger, Nancy R. |
| Source Sets | Oregon State University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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