Juggling efficiency. An ethnographic study exploring healthcare seeking practices and institutional logics in Danish primary care settings

Soc Sci Med. 2015 Mar;128:239-45. doi: 10.1016/j.socscimed.2015.01.037. Epub 2015 Jan 22.


This article explores the mutually constituting relationship between healthcare seeking practices and the socio-political context of clinical encounters. On the basis of ethnographic fieldwork carried out in the context of Danish primary care (general practice) and inspired by recent writings on institutional logics, we illustrate how a logic of efficiency organise and give shape to healthcare seeking practices as they manifest in local clinical settings. Overall, patient concerns are reconfigured to fit the local clinical setting and healthcare professionals and patients are required to juggle efficiency in order to deal with uncertainties and meet more complex or unpredictable needs. Lastly, building on the empirical case of cancer diagnostics, we discuss the implications of the pervasiveness of the logic of efficiency in the clinical setting and argue that provision of medical care in today's primary care settings requires careful balancing of increasing demands of efficiency, greater complexity of biomedical knowledge and consideration for individual patient needs.

Keywords: Cancer; Denmark; General practice; Healthcare seeking; Help-seeking; Patient delay; Primary care.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anthropology, Cultural
  • Denmark
  • Efficiency, Organizational*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Primary Health Care*
  • Process Assessment, Health Care*