Moral Economy of Commodified Health Care

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cavateez

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Hey guys,

Has anyone here read "Learning the Moral Economy of Commodified Health Care: "Community Education," Failed Consumers, and the Shaping of Ethical Clinician-Citizens" by Michele Rivkin-Fish? If so, what is your thought on it? Do you think the author was accurate or fair?

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Yes. I'm quite surprised that someone else here knows about it, actually. I think it is important because there is such a dearth of ethnographic research on the dental profession and on dental education. Why are you asking about it?

What do you mean by "accurate or fair?" Are you referring to the research design?
 
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Unfortunately I don't have access to the pdf, but I took a peek at the abstract. I completely agree with the her statement at the end-

"Finally, I argue that promoting commitments to social justice in health care should not rely on cultivating altruism, but should instead be pursued through educating new practitioners about the lives of poor people, the causal relationships between poverty and poor health, and attention to the structure of health care and provider–patient interactions. This approach involves shining a critical light on America’s commodified health care system as an arena based in relations of power and inequality."

Predental and future dental students need a better understanding of how structural influences of race, poverty, culture, etc. create some of the patterns we see today in oral health disparities. We obviously all have some superficial knowledge of oral health disparities, but ethnographic studies can give us a much richer and specific account of exactly how these disparities arise. And we can use that knowledge to inform our future efforts to address community health problems. Also, it is good to learn more about the political economy of the American health system (and insurance system) and safety net as a whole because we will soon become practitioners in that system! I'll try and see if I can get a copy of the pdf so I can give you a better response!
 
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Sounds like something I need to read. I'll have to add that to my winter break reading list. So far, I'm halfway through "The Fabric of the Cosmos" by Brian Greene. Hoping to get through that and "Paradise Lost" by John Milton in the next week or so.
 
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Yes. I'm quite surprised that someone else here knows about it, actually. I think it is important because there is such a dearth of ethnographic research on the dental profession and on dental education. Why are you asking about it?

What do you mean by "accurate or fair?" Are you referring to the research design?

I totally agree that there is not enough ethnographic research on the dental profession and on dental education. It seems that most of the focus is on medicine, even though dentists probably deal with more patients on a day to day basis.

I am asking about this paper because it was an assigned reading for one of my classes and it really caught me by surprise. It was uncomfortable to see how dental students are implicitly taught it's ok to provide substandard care to poor patients. This is very worrying to me since many (maybe all) dental schools really push/showcase community services. As an incoming dental student, I don't want to be caught in this cycle of providing poor care to disadvantaged patients. I want to see if other pre-dental/current dental students are aware of this issue.

When I ask about the article being "accurate or fair", I guess I am really asking "Do you see this happening in the dental field? Or at your dental school?" I know that since this is an ethnography, the scope is small (the author probably followed UNC dental school), but how applicable is it to dentistry across the U.S? As a follow up question, do you think the moral economy and commodified health care explain why some dentists may feel guilty for charging patients, especially poor patients (a topic in a recent thread) for dental procedures?
 
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