What happens to health professionals when the ill patient is the health care system? Understanding the experience of practising medicine in the Romanian socio-cultural context

Br J Health Psychol. 2013 Sep;18(3):663-79. doi: 10.1111/bjhp.12010. Epub 2012 Dec 6.


Objectives: Our aims were to investigate the sources of work strain and stress, and the way in which they are experienced by Romanian health professionals in a work context shaped by the ongoing 20 years long reform of the national health care system.

Design: An exploratory, qualitative design was used to investigate medical professionals' perceptions of stress and work strain.

Methods: Twenty eight interviews and two focus groups were conducted with 38 physicians, residents and nurses, between the age of 26 and 53. A semi-structured interview guide was used for data gathering and the major themes were identified using thematic analysis of the transcripts.

Results: Three themes emerged in the analysis: governance and health system management, scarcity of resources, and health system reputation. Health professionals described the image of a suffering health system, exhausted by an inconsistent management plan, underfunded and understaffed; a system that is a constant source of discontent, bitterness and doubts for them and their patients.

Conclusions: Romanian health professionals' experiences reveal a health care system which after 20 years of reform managed to shape a learned helplessness culture within the medical community and drive a large proportion of its workforce across the borders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Culture*
  • Female
  • Focus Groups
  • Health Personnel / organization & administration
  • Health Personnel / psychology*
  • Health Policy / economics*
  • Health Policy / legislation & jurisprudence
  • Health Resources / economics
  • Health Resources / supply & distribution*
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Qualitative Research
  • Romania
  • Stress, Psychological*
  • Workplace / economics
  • Workplace / psychology*