Escaping the scarcity loop

Abstract

We belong to a group of medical educators who share a concern about pressures in our work that threaten our capacity for reflection and creativity. We meet regularly to discuss papers that might enhance our practice and recently came across one by Arthur Frank in which he outlines sociological influences on medical practice. Frank argues that sociologists have a duty to uncover the unexamined assumptions that underlie the discourses of today's society and to question these when needed. We were intrigued by Frank's use of the term “scarcity loop” to describe an assumption that he believes dominates health care. He describes this as “the endemic contradiction in health care between the hopes, desires and expectations that capitalist techno-science thrives on generating, and the realities of what can be delivered and who can afford what”. Frank proposes that “the task for social science is to refuse to treat the scarcity loop as inevitable and instead to critique the effects of positioning scarcity as the premise of virtually all health care decision making”.