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Corporate Logic in Clinical Care: The Case of Diabetes Management
Author(s) -
Hunt Linda M.,
Bell Hannah S.,
MartinezHume Anna C.,
Odumosu Funmi,
Howard Heather A.
Publication year - 2019
Publication title -
medical anthropology quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.855
H-Index - 55
eISSN - 1548-1387
pISSN - 0745-5194
DOI - 10.1111/maq.12533
Subject(s) - health care , quality (philosophy) , business , clinical practice , work (physics) , public relations , nursing , medicine , political science , economics , economic growth , epistemology , engineering , mechanical engineering , philosophy
As large corporations come to dominate U.S. health care, clinical medicine is increasingly market‐driven and governed by business principles. We examine ways in which health insurers and health care systems are transforming the goals and means of clinical practice. Based on ethnographic research of diabetes management in a large health care system, we argue that together these organizations redefine clinical care in terms that prioritize financial goals and managerial logics, above the needs of individual patients. We demonstrate how emphasis on quality metrics reduces clinical work to quantifiable outcomes, redefining diabetes management to be the pursuit of narrowly defined goal numbers, despite often serious health consequences of treatment. As corporate employees, clinicians are compelled to pursue goal numbers by the heavy emphasis payers and health systems place on quality metrics, and accessing the required medications becomes the central focus of clinical practice.