2: Research methodology: tracking the role of medical doctors in healthcare reforms

Publication Date:
28 Jan 2022
Pages:
23–28
DOI:
https://doi.org/10.51952/9781447352167.ch002
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The objective of empirically exploring the role of medical doctors in healthcare reforms and policy changes raises a number of methodological questions. What data set should be considered? What is the appropriate period of study (that is, when should analysis of reforms start and end our)? What context-specific elements, whether jurisdictional or situational, influence agency in healthcare reforms? What characterises the roles played by various actors in the reform process? With what influence on context and policy outcomes? What methods should be used to compare case studies? These questions led us to consider methodological developments in contextualist and process research (Mintzberg and Waters, 1982; Pettigrew, 1987, 2012; Langley, 1999), which appear as a plausible way to approach policy research. We thus look at policy changes, such as healthcare reforms, as a continuing system in becoming (Pettigrew, 1987; Tsoukas and Chia, 2002). We rely on comparative longitudinal case studies (Fitzgerald and Dopson, 2009) to track the evolving dynamics of healthcare reforms and medical politics in two national empirical contexts: the NHS in England and the healthcare systems of two Canadian provinces: Quebec and Ontario.

A number of logical arguments support the selection of these two national jurisdictions for our research. Both have a tax-based PFHS. Both have been fertile ground for healthcare reforms and are frequently selected as case studies in comparative health policy analysis (Tuohy, 1999, 2018).

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