Abstract
ABSTRACT Purpose: Sweden has tried to speed up the process of early cancer detection by standardization of care. This increased focus on early cancer detection provides people with a conflicting norm regarding the importance of recognizing possible cancer symptoms and the responsibility of not delaying seeking care. Based on existing norms about patients’ responsibility and care seeking, this study explores how patients experience encounters with primary care physicians when they seek care for symptoms potentially indicating cancer. Methods: Thirteen semi-structured interviews were conducted with patients receiving care for symptoms indicative of cancer in one county in northern Sweden. Data was analysed with thematic analysis. Results: The common notion of describing patients as customers in a healthcare context does not sufficiently capture all aspects of what counts as being a person seeking care. Instead, people interacting with primary care face a twofold role in where they are required to take the role not only of customer but also of seller. Consequently, people shift between these two roles in order to legitimize their care seeking. Conclusions: Standardization oversimplifies the complexity underlying patients’ experience of care seeking and interaction with healthcare. Hence, healthcare must acknowledge the individual person within a standardized system.
Highlights
The increased focus in society on early detection of cancer provides people with a new norm regarding the importance of recognizing possible cancer symp toms and not delaying care seeking (e.g., Quaife et al, 2013; Simon et al, 2010).This norm places the responsibility of seeking healthcare in a timely manner on people (Robb et al, 2009; Simon et al, 2010)
This paper explores these conflicting norms by focusing on patients’ experiences of encounters with primary care physi cians (PCPs) where standardized cancer patient pathways (CPPs) have been adopted
In view of the conflicting norms that people face when interacting with the healthcare system outlined earlier in this paper, our results suggest that patients experience a twofold role during encounters with physicians in primary care
Summary
The increased focus in society on early detection of cancer provides people with a new norm regarding the importance of recognizing possible cancer symp toms and not delaying care seeking (e.g., Quaife et al, 2013; Simon et al, 2010) This norm places the responsibility of seeking healthcare in a timely manner on people (Robb et al, 2009; Simon et al, 2010). Following the norm of being a “good citizen” people report hesitating to seek care in order to not waste health care resources, including their doctor’s time (Andersen et al, 2011; Whitaker et al, 2015) These norms appear to underlie a growing ambivalence found in people's interaction with the healthcare system (Ziebland et al, 2019), and include conflict ing responsibilities related to care seeking. Previous research has focused less about patients’ experiences of con flicting norms during interactions with healthcare; in this article, we use the case of patients seeking care for symptoms potentially indicating cancer
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