Physician practice variation: A symbolic interactionist perspective

I-Ching Huang, Purdue University

Abstract

While significant variations in physicians' practice behavior are well documented, the determinants for these variations are largely unexplored. From a symbolic interactionist perspective, patterns of behavior are formulated based on various meanings and definitions. This study examines physicians' self-esteem and reaction to uncertainty to explain variations in their practice behavior. It is hypothesized that (1) physicians' personal characteristics as part of the social identity elements shape their self-esteem, reaction to uncertainty and practice behavior, (2) physicians' self-esteem is not only a social product shaped by their personal characteristics, but also functions as the social force influencing their reaction to uncertainty and their practice behavior; and (3) physicians' definitions of and responses to uncertain situations influence their practice behavior. Analysis of covariance structures, implemented within a LISREL framework, is used to test the hypothesized causal relations. On the basis of the data collected from 75 physicians at a large teaching hospital in Taiwan, the findings indicate physicians' practice behavior is a function of their specialty, previous academic performance, self-worth and stress from uncertainty. Physicians' self-efficacy, shaped by their gender, experience and previous academic performance, influences the amount of stress they experience under uncertainty, which, in turn, affects practice behavior. Physicians' self-worth, on the other hand, affected by experience and previous academic performance only, has direct effects on practice behavior but not on their willingness to disclose uncertainty. In sum, physicians, who report higher levels of self-worth and less stress from uncertainty, show more effective and efficient practice behavior. The theory that individuals' meanings/definitions of objects and situations influence their behavior is supported.

Degree

Ph.D.

Advisors

Anderson, Purdue University.

Subject Area

Sociology|Social research|Health care

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