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Health care for the poor--An exploration of primary-care physicians' perceptions of poor patients and of their helping behaviors

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  • Monnickendam, Menachem
  • Monnickendam, Shlomo M.
  • Katz, Chana
  • Katan, Joseph

Abstract

This paper explores the ways in which primary-care physicians in Israel perceive and help poor patients. Our findings are based on a qualitative study that utilized a focus group and in-depth interviews with 16 primary-care physicians who qualified both in Israel and in the former Soviet Union, and who work in community clinics one Health Maintenance Organization serving poor populations of diverse cultural, ethnic and socioeconomic backgrounds (immigrants from the former Soviet Union and from Ethiopia, Bedouin, ultra-orthodox Jews, the chronic poor, and the 'new' poor). It was found that the physicians presume causality between poverty and health, identify and distinguish between different types of poverty, and make associations based on the type of poverty and type of patient problem. Their thinking on poverty is patient-oriented rather than socially oriented. An analysis of these findings resulted in a conceptualization of five types of physician helping behavior: emotional and personal instrumental, reinforcing socially desirable behavior, preferential help and bending the rules, rights realization and working the system, and minimal community involvement. The components of this conceptual model depict and chart issues affecting the helping behavior of the primary-care physician, i.e., type of poverty, type of problem, administrative context and, particularly, physician attributes, such as gender and country where notable. Our findings reveal little social consciousness on the part of the physicians, and we conclude with remarks on the potential for change in this area.

Suggested Citation

  • Monnickendam, Menachem & Monnickendam, Shlomo M. & Katz, Chana & Katan, Joseph, 2007. "Health care for the poor--An exploration of primary-care physicians' perceptions of poor patients and of their helping behaviors," Social Science & Medicine, Elsevier, vol. 64(7), pages 1463-1474, April.
  • Handle: RePEc:eee:socmed:v:64:y:2007:i:7:p:1463-1474
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    References listed on IDEAS

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    1. Remennick, Larissa I., 1999. "Preventive behavior among recent immigrants: Russian-speaking women and cancer screening in Israel," Social Science & Medicine, Elsevier, vol. 48(11), pages 1669-1684, June.
    2. Eli Berman, 2000. "Sect, Subsidy, and Sacrifice: An Economist's View of Ultra-Orthodox Jews," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(3), pages 905-953.
    3. Kawachi, Ichiro & Kennedy, Bruce P. & Gupta, Vanita & Prothrow-Stith, Deborah, 1999. "Women's status and the health of women and men: a view from the States," Social Science & Medicine, Elsevier, vol. 48(1), pages 21-32, January.
    4. Gross, Revital & Harrison, Michael, 2001. "Implementing managed competition in Israel," Social Science & Medicine, Elsevier, vol. 52(8), pages 1219-1231, April.
    5. Parizot, Isabelle & Chauvin, Pierre & Paugam, Serge, 2005. "The moral career of poor patients in free clinics," Social Science & Medicine, Elsevier, vol. 61(6), pages 1369-1380, September.
    6. Fredrik Andersson & Carl Hampus Lyttkens, 1999. "Preferences for equity in health behind a veil of ignorance," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 369-378, August.
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    Cited by:

    1. Miki Malul, 2019. "Poverty and Social Policy: Perceptions Versus Reality," Poverty & Public Policy, John Wiley & Sons, vol. 11(4), pages 291-301, December.

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