Distrusting doctors' evidence: a qualitative study of disability income support policy makers

Australian Health Review : a Publication of the Australian Hospital Association
Ashley McAllister, Stephen R Leeder

Abstract

Objective The aim of the present study was to describe how policy makers (bureaucrats and politicians) in Australia and Ontario (Canada) perceive evidence provided by doctors to substantiate applications for disability income support (DIS) by their patients with mental illnesses. Because many mental illnesses (e.g. depression) lack diagnostic tests, their existence and effects are more difficult to demonstrate than most somatic illnesses. Methods Semi-structured interviews were conducted with 45 informants, all influential in the design of the assessment of DIS programs. The informants were subcategorised into advocates, legal representatives, doctors (general practitioners (GPs) and specialists (e.g. psychiatrists)), policy insiders and researchers. Informants were found through snowball sampling. Following the principles of grounded theory, data collection and analysis occurred in tandem. Results Informants expressed some scepticism about doctors' evidence. Informants perceived that doctors could, due to lack of diagnostic certainty, 'write these things [evidence] however [they] want to'. Psychiatrists, perceived as having more time and skills, were considered as providing more trustworthy evidence than GPs. Conclusion Doctor...Continue Reading

References

Jan 1, 1979·Journal of Health Politics, Policy and Law·D A Stone
May 2, 2000·The Australian and New Zealand Journal of Psychiatry·S HendersonW Hall
Jun 25, 2003·Social Science & Medicine·Pia Asbring, Anna-Liisa Närvänen
Sep 7, 2007·Lancet·Martin PrinceAtif Rahman
Jun 10, 2008·Scandinavian Journal of Public Health·Malin S SwartlingRolf A Wahlstrom
Feb 19, 2010·Work : a Journal of Prevention, Assessment, and Rehabilitation·Monika EngblomCarl Edvard Rudebeck
Sep 10, 2011·BMC Medical Research Methodology·Alexandra SbarainiAnthony Blinkhorn
Dec 7, 2013·Australian Health Review : a Publication of the Australian Hospital Association·Harvey A WhitefordWayne D Hall

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