Swedish physicians' perspectives on work and the medical care system--III: Private practitioners on the public system

This paper reports the results of focused interviews in 1978-1979 with Swedish physicians in private practice about the public system of medical care in Sweden. They were asked about the system as a work environment for physicians and as a system of care for patients. Respondents, who were outside the public system (although financed mainly by public mechanisms) said the public system as a place to work had advantages in its high technical quality, facilities for research and training, and the capacity to treat complicated disease; its disadvantages were said to be inefficiency, lack of communication, poor patient care, and blocked mobility for physicians without doctorates. As a system of care, its one advantage was said to be that it provided care at less out-of-pocket cost to patients; its reported disadvantages were poor quality care and a tendency to be overly comprehensive. These perspectives are discussed with respect to their structural and historical contexts.