Bør leger bidra til å utjevne sosial ulikhet i helse?

Abstract

Which role the health care system has and should have in reducing social inequality in health is unclear. The study objective is to gain knowledge about what Norwegian medical doctors believe their role should be. A questionnaire on how doctors take socioeconomic factors into account when treating patients was sent to a representative sample of 1,650 Norwegian doctors in 2008. 1,153 (70 %) doctors responded. 55 % believed doctors should contribute to reducing social inequality by offering patients with a low socioeconomic status extra help. However, the majority reported that they seldom/never take the patients' socioeconomic situation (such as bad private economy [81 %], little education [80 %], or unemployment [85 %]) into account in their clinical work. Some would consider lack of a social network (33 %), or heavy caring responsibilities (43 %) to be relevant. When responding to the question about how medical doctors take socioeconomic factors into account, 71 % said they give advice, 69 % spend more time, and 58 % offer an extra consultation. More regular GPs than other doctors reported they would take bad private economy (31 % vs. 15 %), unemployment (25 % vs. 12 %), or heavy caring responsibilities (54 % vs 39 %) into account. To treat all patients equally is a fundamental value among doctors. Practical implications of equal treatment to all are not clear. Apparently inconsistent answers reveal a need for a professional and political clarification of which principles of equality that should guide doctors' practice.