Health Care Delivery as "Noisy", Bureaucratically Organised Information Exchange Systems
In this lecture Prof. Cicourel argues that clinical medicine and health care delivery are "noisy" information exchange systems because the demand for services to be rendered by professionals, technicians, and administrative support staff have become increasingly compromised by bureaucratic constraints and rising costs. In day-to-day communicative settings, health care personnel must cope with "normal" limited attention and memory resources while satisfying increased regulations and informal practices, status differences, and a chain of command inherent in all bureaucracies. Limited health care resources - combined with constraints upon interactional routines - can mean delays in receiving services and differences in quality even for those eligible for health care. Managed Health care Organizations (HMOs) and Preferred Provider Organizations (PP0s) in the United States are implemented with a variety of communicative and regulative constraints that can be confusing to patients and health care personnel concerned about the adequacy of services. In this increased bureaucratic set-up, educating patients about dietary, medicinal, physical activity compliance etc remains a low priority despite the fact that it could both improve their health and reduce costs.