Not-So-Informal Relationships. Selective Unbundling of Maternal Care and the Reconfigurations of Patient–Provider Relations in Serbia

Abstract

Social practices, such as connections (veze) and gift giving, are often labelled as socialist legacies that lead to corruption and are contrary to the establishment of market practices in postsocialist societies. This paper investigates the effects of the selective opening of aspects of maternal care to market practices on patient–provider relationships. Ethnographic research indicates that doctors are navigating between the constraints and opportunities afforded by both sectors, private and public, to negotiate their daily interactions with patients. In the attempt to maintain both authority and trust with their patients in a very precarious economic and social context, doctors have to be both medical experts and entrepreneurs. This practice points towards the conclusion that it may not be the legacies of socialism that have created the need for finding new ways of forging connections between medical providers and their patients, but rather the unbundling of socialist healthcare into the market.

Civil Servants and Non-Western Migrants’ Perceptions on Pathways to Health Care in Serbia—A Grounded Theory, Multi-Perspective Study

“…Such high value was perceived as one of the main reasons for the pervasiveness of informal patient payments, believing that doctors needed motivation for working under miserable conditions or to receive gratitude for the service given to patients. Several respondents mentioned that it was a cultural phenomenon to view doctors as almost ‘godlike’ which correspond to other literature, finding patient-provider relationships to vary according to culture [ 67 , 68 , 69 ]. Health care systems and governance systems varies and are thus shaped by the social context and relies heavily on the inclusiveness and responsiveness to culture, social justice and human rights [ 2 ].…”

Postsocialist Mediterranean

“…Finally, there has also been a set of studies that employ what I call a scalar gaze, exploring both the political economy of favors as well as their eff ect on personhood and interpersonal relationships (e.g., Dunn 2004: 119-125;Stan 2012). Some of these works look at how various postsocialist actors use favors to fl exibly move across boundaries between public and private arenas, increasing their economic and/or political power in doing so (Pantović 2018;Wedel 2009). Let me explain what a scalar gaze entails as an analytical approach and how it can help us to understand the socio-political and economic eff ects of favors diff erently.…”

Somebodies or nobody’s patient: The importance of social positioning and informal relations during childbirth in Serbia

“…На овај начин жене претварају свој економски капитал -плаћање додатног вођења трудноће у приватној пракси -у социјални капитал, везу са гинекологом као вид привилеговане позиције и заштите унутар државног породилишта. Веза се, дакле, купује и претвара из економског капитала плаћањем услуге у приватној пракси у социјални капитал који се одржава у бољем третману у државној установи (Pantović 2016;Pantović 2018).…”