Podiatry, Patients, Policy and Power
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NHS Podiatry (Chiropody) services in the UK are provided for patients with some pathology. Rationing of these services may take place with individual trusts applying varying criteria to patient referrals for treatment. A podiatric patient without a medical complication such as Diabetes Mellitus or Rheumatoid Arthritis, may or may not obtain this free NHS treatment in some trusts, or treatment may be made available on an infrequent or irregular basis depending on local policy. The divergent nature of the podiatrist/patient objectives was thought to lead to some conflict within the dyad. The question that stimulated this research work was "What sort of discourses, rhetoric and scripts do an NHS podiatrist and patient draw upon in order to negotiate NHS podiatric treatment". Naturally occurring data was obtained by audio-recording the interactions between an NHS podiatrist and patient during a first assessment and treatment appointment. The data was transcribed and then analysed using discursive techniques (Guided by Parker1)to reveal the nature and sources of conflict. Issues of communication, power relations, and claims to legitimacy were found to be evident, and the interface of the patient denial of podiatric legitimacy was observed. This evidence may be subsequently used to inform policy and to support the patients need to continue to obtain free NHS podiatric treatment without rationing. References 1. Parker, I., Discourse Dynamics: Critical Analysis for Social and Individual Psychology. London. Routledge. 1992.
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