Hurt running from police? No chance of (pain) relief: The social construction of deserving patients in emergency departments

Hinze, Susan W.; Webster, Noah; Chirayath, Heidi Taylor; Tamayo-Sarver, Joshua H.

doi:10.1108/s0275-4959(2009)0000027013

Cited by 18 publications

(7 citation statements)

References 50 publications

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“…Perceptions about them have resulted in this patient group encountering stigma and other negative consequences of their substance use, which in turn may affect their care seeking, care delivery and treatment [19][20][21]. Hinze et al suggest that physician's decisions are shaped within a climate of fear, and that clinicians are more likely to prescribe narcotics to patients they perceive as trustworthy [22]. In the current case, the HIE system could be used to confirm their negative presumptions about the patient.…”

Section: Discussionmentioning

confidence: 92%

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Revisiting sociotechnical systems in a case of unreported use of health information exchange system in three hospital emergency departments

Ozkaynak

Brennan

2012

Evaluation Clinical Practice

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Section: Discussionmentioning

confidence: 92%

“…Hinze et al . suggest that physician's decisions are shaped within a climate of fear, and that clinicians are more likely to prescribe narcotics to patients they perceive as trustworthy [22]. In the current case, the HIE system could be used to confirm their negative presumptions about the patient.…”

Section: Discussionmentioning

confidence: 93%

Revisiting sociotechnical systems in a case of unreported use of health information exchange system in three hospital emergency departments

Ozkaynak

Brennan

2012

Evaluation Clinical Practice

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“…Patients with identical presenting problems or clinical requests can encounter differential treatment based on seemingly irrelevant social and behavioural characteristics. For example, providers have reported greater willingness to prescribe opioids for pain relief when the patient was injured during a ladder fall versus running from the police . To the extent that socially acceptable versus socially stigmatized patient characteristics yield more favourable treatment, providers may be more willing to prescribe PrEP for patients reporting continued condom use and monogamy versus condomless sex and non‐monogamy.…”

Section: Introductionmentioning

confidence: 99%

Prevention paradox: Medical students are less inclined to prescribe HIV pre‐exposure prophylaxis for patients in highest need

et al. 2018

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IntroductionDespite healthcare providers’ growing awareness of pre‐exposure prophylaxis (PrEP), prescription rates remain low. PrEP is an efficacious HIV prevention strategy recommended for use with condoms but still protective in their absence. Concern about the impact of PrEP on condom use and other risk behaviour is, nonetheless, among the barriers to prescription commonly reported. To understand the implications of this concern for PrEP access, we examined how medical students’ willingness to prescribe PrEP varied by patients’ condom use and partnering practices. We also assessed the perceived acceptability of various reasons for condom discontinuation with PrEP.MethodsAn online survey was distributed to 854 medical students in the Northeastern US in 2015. Participants (n = 111) were surveyed about their willingness to prescribe PrEP for each of six male patients who systematically differed in their reported condom use (sustained use, sustained nonuse, or discontinuation with PrEP) and partnering practices (single male partner with untreated HIV or multiple male partners of unknown HIV status). Participants also reported perceived acceptability of four reasons for condom discontinuation: pleasure, sexual functioning, intimacy, and conception.ResultsWillingness to prescribe PrEP was inconsistent with patient risk: When the patient used condoms and planned to sustain condom use, most participants were willing to prescribe PrEP – 93% if the patient had a single partner and 86% if the patient had multiple partners. Fewer were willing to prescribe if the patient did not use condoms and planned to sustain nonuse (53% and 45%, respectively) or used condoms but planned to discontinue use (27% and 28%). Significantly fewer participants were willing to prescribe for a patient with multiple partners versus a single partner when the patient reported sustained condom use or sustained condom nonuse. The number of participants who were willing to prescribe was similarly low for a patient with multiple partners versus a single partner when the patient reported that he planned to discontinue condom use. More participants accepted a patient discontinuing condoms for conception (69%) than for intimacy (23%), pleasure (14%), or sexual functioning (13%).ConclusionMedical students’ clinical judgments were misaligned with patient risk and suggest misconceptions or personal values may undermine provision of optimal HIV prevention services.

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“…Roth (1972) and Jeffery (1979) extended this discussion to the public ER and prompted a number of sociological studies (e.g., Hinze et al 2009; Kurz 1987; Lincoln 2006; Mizrahi 1985; Vassey 2001). These scholars document three findings relevant for this article.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

“…Previous studies of pain medication document how people from low social-status groups are less likely to be prescribed pain medication at the point of hospital discharge (Hinze et al 2009; Todd et al 2000). In stark contrast stands the world of triage, where pain medication is ubiquitous and plays a central role in managing the front room waiting list patients.…”

Section: Rushing and Delaying Health Care In The Era Of Mass Imprisonmentioning

confidence: 99%

Public Emergency Room Overcrowding in the Era of Mass Imprisonment

Lara‐Millán

2014

Am Sociol Rev

122

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Although sociologists have long studied public emergency rooms (ERs) and their service delivery to the urban poor, little is known about how crime control and criminal justice contact affect ER admission decisions—a critical oversight given the documented increase in incarceration rates, intensification of policing, and proliferation of crime control language in public institutions. Using ethnographic methods and a count of ER admission decisions (N = 1,114), this article describes the continual rushing and delaying of medical resources to patients based on their perceived criminality or actual relationship to the criminal justice system. These dynamics develop through four processes: (1) widespread administration of pain medication, which associates waiting patients with criminal narcotics; (2) deployment of criminal stigma along race and gender lines to select some qualified patients over others; (3) patrolling of waiting rooms by police; and (4) rushing of beds to vast numbers of arrestees, inmates, and witnesses. Key to these findings is that if the urban poor happen to be wards of the criminal justice system, they receive rushed health care resources, but if they enter health care organizations on their own accord they are policed, delayed, and deterred from accessing care.

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Hurt running from police? No chance of (pain) relief: The social construction of deserving patients in emergency departments

Cited by 18 publications

References 50 publications

Revisiting sociotechnical systems in a case of unreported use of health information exchange system in three hospital emergency departments

Revisiting sociotechnical systems in a case of unreported use of health information exchange system in three hospital emergency departments

Prevention paradox: Medical students are less inclined to prescribe HIV pre‐exposure prophylaxis for patients in highest need

Public Emergency Room Overcrowding in the Era of Mass Imprisonment

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