Social Representations of Healthcare Organisational Models and Professional Practice Among Public-Sector Physicians...

Background/Objectives: Healthcare workforce shortages and the challenges facing healthcare professionals are among the most pressing issues confronting contemporary health systems. This study examines the social representations of public, private, and public-private partnership (PPP) healthcare organisational models and professional practice elicited from public-sector physicians and nurses in Portugal. Methods: A cross-sectional survey was conducted between October 2022 and May 2023 using a non-probability sample of 308 physicians and nurses classified as public-sector professionals. Participants completed a free-association task concerning the public, private, and PPP healthcare models and their professional practice. The evoked terms were examined using prototypical analysis within the structural approach to Social Representations Theory. The representation of the public healthcare sector included elements such as accessibility, universality, equity, slowness, disorganisation, and resource limitations. The private healthcare sector was characterised by elements including cost, profit, speed, organisation, inaccessibility, and service quality. Results: The representation of PPPs included better management, efficiency, profit, interests, and quality, alongside a relatively frequent "No opinion" response. Professional practice was characterised by elements including caring, dedication, empathy, resilience, exhaustion, perceived undervaluation, and remuneration. Conclusions: These findings describe the social representations elicited from the present sample of public-sector physicians and nurses and should not be interpreted as evidence of objective differences between healthcare organisational models or as direct measures of motivation, resilience, burnout, sector preference, or working conditions. The findings are exploratory and hypothesis-generating and may inform future comparative research involving professionals working across different healthcare settings, as well as studies using dedicated measures of professional and occupational outcomes.