(RE)SEARCH FOR THE DOCTOR IN HEALTH POLICY

Abstract

The article offers an analysis of the «position of the doctor» in the context of the healthcare system, where he acts as a trusted professional who must operate according to the principles of approved and institutionally supported models of doctor-patient relationships (DPR) in accordance with current health policy, as well as in the context of ordinary medical practice, where doctors are bound to deal directly with patients – usually abnormal, incompetent and disobedient – who always have their own ideas about «health», «the goals of medicine», «well-being», etc., and, as consumers, demand solutions to issues and problems «related to health». According to the authors, the general problem context is the uncertainty and impossibility of a monistic definition of the concept of «health», which, however, does not prevent it from occupying a central place in normative communication between doctor and patient, appearing in it as their common goal and as the subject of constructive discussions of mutually acceptable solutions for achieving it. At the same time, the «common language», which is the key to reaching agreement on the scope, methods, and expected results of medical intervention through a certain distribution of power and responsibility between the doctor and the patient, cannot be imagined as a given, ready-to-use, licensed utility, but comes from negotiations and dotted conspiracies between the doctor and a specific patient, that is, through the formation of their power relations. The latter (in terms of Foucault's micro-physics of power) are understood as special, individual, uncertain «low» tactics, which are finalised and formalised at the «upper echelons» of health policy using DPR regulatory models. Thus, a true practising physician should be understood as someone who, in each case (patient), must arbitrarily determine the level of their «power conductivity».