When the standards aren't standard: evidence-based medicine in the Russian context.
This paper examines the uses of evidence-based medicine (EBM) in post-Soviet Russia through the use of semi-structured interviews. It asks what it means to talk about practicing evidence-based medicine in a setting where the context of practice presents considerable barriers to the implementation of EBM principles. Drawing on interviews with Russian physicians, medical students and users of the healthcare system, the paper argues that in post-Soviet Russia EBM serves as a strategic discourse for segments of the medical profession. With the collapse of the U.S.S.R. the healthcare system has been going through a period of crisis, and Russian physicians are finding that they have to redefine their professional identity with respect to the domestic and the international context and have to seek new sources for legitimizing their professional position. The western origins of EBM endow this rhetoric with considerable power in the Russian context and render it a very useful tool in the project of redefinition.
Geltzer
Anna
A
Department of Science & Technology Studies, Cornell University, 311 Rockefeller Hall, Ithaca, NY 14850, USA. ag322@cornell.edu
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D007407:Interviews as Topic; D009936:Organizational Innovation; D011209:Power, Psychological; D011332:Privatization; D017009:Professional Autonomy; D036301:Qualitative Research; D012426:Russia; D012962:Sociology, Medical / Q000639:trends*; D013222:State Medicine / Q000191:economics / Q000458:organization & administration* / Q000639:trends