Int J Health Policy Manag July 2021 PMID 33131227

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India as Street Level Bureaucrats.

Sudha Ramani, Lucy Gilson, Muthusamy Sivakami, Nilesh Gawde

Mentions

22
Peak: 8 in Jun 2021
across 2 sources since Oct 2020

Extended reach

79,112
potential audience

Total likes

54

Video views

1,128

Mentions per month

Oct 2020 – Oct 2023

Where it's discussed

  • X / Twitter20 posts
  • YouTube2 videos

AI synopsis

What people are saying

The analyses show strong agreement with the article's portrayal of doctors' resignation and risk aversion, highlighted by phrases like 'deep loss of professional identity' and references to 'resource constraints' and 'top-down policies.' The tone and repeated citations of the study indicate both high interest and deep engagement, while the discussion of systemic challenges reflects meaningful awareness of their potential impact on healthcare delivery.

AgreementStrong agreement

Most discussions acknowledge the legitimacy of the article's findings, emphasizing the challenges faced by primary care doctors in India.

InterestHigh interest

The discussions demonstrate high interest, with repeated mentions of resource constraints, policy imposition, and professional identity loss.

EngagementHigh engagement

There is active engagement, including sharing insights, presenting the paper, and reflecting on the implications for healthcare policy.

ImpactModerate impact

The conversations suggest the article raises awareness about systemic issues, though some participants focus more on understanding than immediate action.

Abstract in brief

  • The study explores how primary care doctors in rural India act as street level bureaucrats, often feeling resigned, conflicted, and risk-averse due to resource constraints, top-down policy impositions, and lack of support, which affect their ability to provide quality care.
  • It shows that doctors modify policies and routines as a way to cope with these challenges, often leading to decreased professional identity and engagement, which in turn hampers effective primary healthcare delivery.
  • Overall, the research emphasizes that doctors' behaviors are shaped by their environment and frustrations, challenging the blame placed solely on them for policy implementation failures in low- and middle-income countries.

Top posts

Most liked on X and Bluesky
IJHPM
@IJHPM · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats https://t.co/8T65Lm7BvU #StreetLevelBureaucracy #PolicyImplementation #PrimaryHealth #Doctors @Lucy_Gilson https://t.co/1k0d30VjnX

Jun 13, 2021 · 20 likes · 7 shares · 2,012 followers View post →
Robert Marten
@MartenRobert · X

Sudha Ramani presenting her paper now --> Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats @SudhaRamani6 @Lucy_Gilson @Sivakami_Mu https://t.co/JlKUMlGVju https://t.co/BvEfUgpui7

Jul 1, 2021 · 6 likes · 3 shares · 10,926 followers View post →
IJHPM
@IJHPM · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India ... https://t.co/C2W0rZX7mr

Oct 28, 2020 · 6 likes · 3 shares · 2,012 followers View post →
IJHPM
@IJHPM · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care #Doctors in #India as Street Level Bureaucrats https://t.co/OYq8PRTQ1Y https://t.co/ej3Lv8WAlI #StreetLevelBureaucracy #PolicyImplementation #PrimaryHealth #IJHPM @Lucy_Gilson https://t.co/84NiK0HOpp

Oct 9, 2023 · 5 likes · 3 shares · 2,012 followers View post →
D. Rajan
@dheepa_rajan · X

Insights from rural India: "Doctors reported..lack of resources, the top-down imposition of programs.. limited support..&professional disinterest in their assigned roles. In response..many doctors ‘routinized’ care, and became resigned and risk-averse.." https://t.co/6TaLKvJKAU

Jun 10, 2021 · 2 likes · 1,084 followers View post →
catale7a
@catale7a · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India as Street Level Bureaucrats Most doctors felt a deep loss of professional identity, and accepted this loss as an inevitable part of a public sector job https://t.co/ba0eoZ57bD

Jun 15, 2021 · 25,212 followers View post →

All mentions

Serius Black
@dnameis_paone · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care #Doctors in #India as Street Level Bureaucrats h…

Oct 9, 2023 · 3 shares · 196 followers View post →
Lucy Gilson
@Lucy_Gilson · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care #Doctors in #India as Street Level Bureaucrats h…

Oct 9, 2023 · 3 shares · 4,869 followers View post →
M. Sivakami
@Sivakami_Mu · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care #Doctors in #India as Street Level Bureaucrats h…

Oct 9, 2023 · 3 shares · 1,130 followers View post →
IJHPM
@IJHPM · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care #Doctors in #India as Street Level Bureaucrats https://t.co/OYq8PRTQ1Y https://t.co/ej3Lv8WAlI #StreetLevelBureaucracy #PolicyImplementation #PrimaryHealth #IJHPM @Lucy_Gilson https://t.co/84NiK0HOpp

Oct 9, 2023 · 5 likes · 3 shares · 2,012 followers View post →
Kabir Sheikh
@docsheikh · X

RT @MartenRobert: Sudha Ramani presenting her paper now --> Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care…

Jul 2, 2021 · 3 shares · 4,577 followers View post →
Saurabh
@queeresearcher · X

RT @MartenRobert: Sudha Ramani presenting her paper now --> Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care…

Jul 1, 2021 · 3 shares · 628 followers View post →
Alliance for HPSR
@AllianceHPSR · X

RT @MartenRobert: Sudha Ramani presenting her paper now --> Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care…

Jul 1, 2021 · 3 shares · 8,566 followers View post →
Robert Marten
@MartenRobert · X

Sudha Ramani presenting her paper now --> Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats @SudhaRamani6 @Lucy_Gilson @Sivakami_Mu https://t.co/JlKUMlGVju https://t.co/BvEfUgpui7

Jul 1, 2021 · 6 likes · 3 shares · 10,926 followers View post →
catale7a
@catale7a · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India as Street Level Bureaucrats Most doctors felt a deep loss of professional identity, and accepted this loss as an inevitable part of a public sector job https://t.co/ba0eoZ57bD

Jun 15, 2021 · 25,212 followers View post →
Sudha Ramani
@SudhaRamani6 · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats ht…

Jun 14, 2021 · 7 shares · 232 followers View post →
Indian Public Health Professional Network
@I_PHPN · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats ht…

Jun 14, 2021 · 7 shares · 494 followers View post →
M. Sivakami
@Sivakami_Mu · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats ht…

Jun 14, 2021 · 7 shares · 1,130 followers View post →
Lucy Gilson
@Lucy_Gilson · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats ht…

Jun 13, 2021 · 7 shares · 4,869 followers View post →
IJHPM
@IJHPM · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in #India as Street Level Bureaucrats https://t.co/8T65Lm7BvU #StreetLevelBureaucracy #PolicyImplementation #PrimaryHealth #Doctors @Lucy_Gilson https://t.co/1k0d30VjnX

Jun 13, 2021 · 20 likes · 7 shares · 2,012 followers View post →
D. Rajan
@dheepa_rajan · X

'Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India as Street Level Bureaucrats' by Sudha Ramani, @Lucy_Gilson et al. https://t.co/GCcqXu8IBm

Jun 10, 2021 · 1,084 followers View post →
D. Rajan
@dheepa_rajan · X

Insights from rural India: "Doctors reported..lack of resources, the top-down imposition of programs.. limited support..&professional disinterest in their assigned roles. In response..many doctors ‘routinized’ care, and became resigned and risk-averse.." https://t.co/6TaLKvJKAU

Jun 10, 2021 · 2 likes · 1,084 followers View post →
@valeryridde mastodon.social
@ValeryRidde · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India ... https://t.co/C2W0rZX7mr

Oct 30, 2020 · 3 shares · 4,900 followers View post →
Saurabh
@queeresearcher · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India ... https://t.co/C2W0rZX7mr

Oct 29, 2020 · 3 shares · 628 followers View post →
Helen Schneider
@schneider_helen · X

RT @IJHPM: Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India ... https://t.co/C2W0rZX7mr

Oct 29, 2020 · 3 shares · 1,282 followers View post →
IJHPM
@IJHPM · X

Sometimes Resigned, Sometimes Conflicted, and Mostly Risk Averse: Primary Care Doctors in India ... https://t.co/C2W0rZX7mr

Oct 28, 2020 · 6 likes · 3 shares · 2,012 followers View post →