When Social Inequalities Make Patients « Difficult »

The Physicians’ Experience

Abstract

While social inequalities in health care are usually examined by objective indicators such as the frequency of care received, they can also be measured by more subjective indicators, such as the assessment that beneficiaries make of their care. This article follows the thread of physicians’ subjectivity rather than that of their patients. More specifically, it explores the feeling of difficulty that doctors may experience when they follow patients who are victims of social inequalities. It is based on the qualitative analysis of general practitioners’ speech practicing in Montreal. These doctors attribute three main sources to their difficulties in following socially disadvantaged patients: 1) the excessive time devoted to these patients, 2) the ineffectiveness of their com- munication means and 3) their helplessness in the face of lacks in resources (income, knowledge and social ties) that they perceive in these patients. Addressing inequalities in healthcare therefore requires a more equal distribution of these resources.