Conceptualizing professional and public interest in the context of Turkey’s health care reforms

Abstract

PurposeThe purpose of this paper is to investigate physicians’ response to reforms in Turkey on the basis of their experience of the changes in the daily work environment. It aims to bridge the gap between health policy and sociology of professions literatures to explain why some public-sector physicians have opposed the recent reforms.Design/methodology/approachThe research adopts a qualitative methodology including semi-structured interviews and content analysis. The fieldwork involves collecting information through written documents and interviews with 23 physicians working in public tertiary hospitals in one large city.FindingsPhysicians’ response combines a concern with material interests, previously conceptualized in terms of erosion of autonomy, with anxiety over damage to their professional image and social status. The particular reform discourse adopted by policymakers disrupts the existing constructions of harmony in the professional discourse between the public and professional interests, and between social value and material interests.Research limitations/implicationsOne major limitation of this paper is its exploratory nature and analysis based on one case study. Future studies that adopt a cross-country comparative approach could help addressing concerns of limited generalizability.Originality/valueEarlier social science literature on health reforms has explained physicians’ opposition in terms of protecting their professional self-interest and fighting against any regulation that could limit their income or autonomy. The paper adopts a broader definition of interests that goes beyond this materialist conception and includes subjective ideas about interests such as values and beliefs about how they serve the public interest. This definition allows us to unpack the relationship between interest and autonomy.