Social science & medicine
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Social science & medicine · Jan 1983
Tips, status and sacrifice: gift giving in the doctor-patient relationship.
This study examines the gifts physicians receive from their patients. Internists in a hospital-based group practice kept diaries of gifts received and were interviewed about their responses and the reasons which they ascribed to the patient's gift-giving. ⋯ Patient gifts are found to be reciprocations for some action on the part of the physician, which the patient, in turn, perceives as a gift. Three categories of gifts, according to their nature and timing, are: (1) gifts as 'tips', given to promote personalized service, to assure the continued interest and the tolerance of the physician; (2) gifts to address the status imbalance in the doctor-patient relationship, either by imposing a non-professional identity on the physician or by redeeming status lost in the sick role; (3) gifts as a sacrifice to the physician who exercises his power on the patient's behalf.
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Most economists have suggested that the growing presence of insurance, including Medicare, Medicaid, Blue Cross and the commercial insurers, is largely responsible for the rapid rise of health care costs in the United States. It is the contention of this paper, however, that the insurance industry in the private sector in the United States may help in the effort to contain costs rather than solely stimulating rapidly increasing costs. ⋯ It is cautioned, however, that although health insurer cost containment efforts will continue to expand in the future, perversities in the U. S. tax laws, potential provider opposition and the complexities of medicine will continue to make cost containment a difficult task.
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Social science & medicine · Jan 1982
Helping and achieving. Compatible or competing goals for men and women in medical school?
This study investigates the attitudes of medical students toward oncology and examines the help- and achievement-orientations of males and females to ascertain whether these orientations are gender-related. Ninety freshmen, 125 sophomores, 83 juniors, and 87 senior medical students responded to questionnaires assessing their attitudes. ⋯ Helping and achieving were compatible goals for these women. Both male and female students were significantly more help-oriented by their senior year but they also felt significantly less effective in helping than did students in the first 3 years.