title: 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.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Babes-Bolyai University, Cluj-Napoca, Romania.
authors.forename: Florina
authors.initials: F
authors.lastname: Spânu
authors.forename: Adriana
authors.initials: A
authors.lastname: Băban
authors.forename: Mara
authors.initials: M
authors.lastname: Bria
authors.forename: Dan L
authors.initials: DL
authors.lastname: Dumitrascu
mesh_terms: D000328:Adult; D003469:Culture; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000458:organization & administration / Q000523:psychology*; D006291:Health Policy / Q000191:economics* / Q000331:legislation & jurisprudence; D006295:Health Resources / Q000191:economics / Q000600:supply & distribution*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012383:Romania; D013315:Stress, Psychological; D017132:Workplace / Q000191:economics / Q000523:psychology*