Are Polish Primary Care Practitioners Social Entrepreneurs?

Keywords: Poland, primary care, social entrepreneurship, doctor-patient relations


In this article I explore the range of entrepreneurial roles played by doctors working in Polish Primary Health Care [Podstawowa Opieka Zdrowotna – POZ]. I use the division into social and strictly business entrepreneurship – whose source comes from economic sciences – in order to examine
what entrepreneurial values rural/small town doctors and their city colleagues recognise and use in their practices. POZ is mainly carried out in private clinics contracted by the National Health Fund [Narodowy Fundusz Zdrowia – NFZ], therefore I look at the values associated with entrepreneurship. I consider these values as visibly altering doctor–patient encounters, thus I analyse doctor’s strategies for establishing his/ her formal and informal relations with patients. I focus my attention on the specific forms of experiencing time in primary care, namely short and long time structures, which I recognise as crucial for interactions between practitioners and their patients. Finally, I put forward the thesis that much of the interaction in POZ offices has the characteristics of symbolic exchange – the reciprocal forms of doctor–patient interactions transfer these encounters beyond purely medical interventions to spaces of mutual cooperation, attachment and trust.


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Author Biography

Hubert Wierciński, Institute of Ethnology and Cultural Anthropology at the University of Warsaw

PhD in ethnology


A b a d í a - B a r r e r o C. E. 2015. Neoliberal justice and the transformation of the moral: the privatization of the right to health care in Colombia. Medical Anthropology Quarterly 30 (1), 62–79.
A u s t i n J., S t e v e n s o n H., We i - S k i l l e r n J. 2006. Social and commercial entrepreneurship: same, different, or both? Entrepreneurship Theory and Practice 30 (1), 1–22.
C u e t o M. 2004. The origins of primary health care and selective primary health care. American Journal of Public Health 94 (11), 1864–1874.
C e r t o T. and Mi l l e r T. 2008. Social entrepreneurship: key issues and concepts. Business Horizons 51, 267–271.
C z a c h o w s k i S. 2002 Środowiskowe uwarunkowania praktyki lekarza rodzinnego (wybrane zagadnienia). Toruń.
C z a c h o w s k i S. 2005 Rola lekarza rodzinnego w praktyce medycznej. Toruń
F a r m e r J. a n d K i l p a t r i c k S. 2009. Are rural health professionals also social entrepreneurs? Social Science & Medicine 69 (11), 1651–1658.
H o l e c k i T., S k r z y p e k M., S z l a p a M. 2013. Kształtowanie wizerunku placówki podstawowej opieki zdrowotnej w kontekście roli lekarza rodzinnego. Studia Ekonomiczne/ Uniwersytet Ekonomiczny w Katowicach 157, 149–156.
I v e r s e n L. 2002. Workload pressures in rural general practice: a qualitative investigation. Scandinavian Journal of Primary Care 20, 139–144.
J a n e s C. R. 2004. Going global in century XXI: medical anthropology and the new primary health care. Human Organisation 63 (4), 457–471.
J a n e s C. R., C h u l u u n d o r j O., Hi l l i a r d C. E., R a k K., J a n c h i v K. 2006. Poor medicine for poor people? Assessing the impact of neoliberal reform on health care equity in a post-socialist context. Global Public Health 1(1), 5–30.
K e n n e d y M. D. 2002. Cultural formations of post-communism emancipation, transition, nation, and war. Minneapolis.
K e s h a v j e e S. 2014. Blind spot: how neoliberalism infiltrated global health. Oakland.
K i l p a t r i c k S., C h e e r s B., Gi l l e s M., Ta y l o r J. 2009. Boundary crossers, communities, and health: exploring the role of rural health professionals. Health & Place 15 (1), 284–290.
Ko w a l s k a - B o b k o I. Decentralizacja a systemy zdrowotne. W poszukiwaniu rozwiązań sprzyjających zdrowiu. Kraków.
Ma t t i n g l y Ch. 1998. Healing dramas and clinical plots. The narrative structure of experience. Cambridge.
Mc K e n n a B. 2010. Take back medical education – the “primary care” shuffle. Medical Anthropology 29 (1), 6–14.
Mc K e n n a B. 2012. The clash of dedical civilizations: experiencing “primary care” in neoliberal culture. Journal of Medical Humanities 33 (4), 255–272.
M u l l i g a n J. 2015. Insurance accounts: the cultural logics of health care financing. Medical Anthropology Quarterly 30 (1), 37–61.
P i ą t k o w s k i W. 2015. Dysfunkcjonalność systemu opieki zdrowotnej w polskiej socjologii medycyny. Zarys problematyki. In A. Ostrowska and M. Skrzypek (eds.), Socjologia medycyny w Polsce z perspektywy półwiecza. Nurty badawcze, najważniejsze osiągnięcia, perspektywy rozwoju. Warszawa,
P i ą t k o w s k i W. and No w a k o w s k a L. 2012. System medyczny w Polsce wobec wyzwań XXI w. Perspektywa krytycznej socjologii zdrowia i choroby. Przegląd Socjologiczny 62(2), 11–29.
R h o d e s L. A. 1996. Studying biomedicine as a cultural system. In C. F. Sargent and T. M. Johnson (eds.), Medical anthropology: a handbook of theory and method. Revised edition. London, 165–180.
R y l k o - B a u e r B. and F a r m e r P. 2002. Managed care or managed inequality? A call for critiques of market-based medicine. Medical Anthropology Quarterly 16 (4), 476–502.
S t o n e D. A. 1997. The doctor as businessman: the changing politics of a cultural icon. Journal of Health Politics, Policy and Law. 22 (2), 533–556.
T h o m p s o n J. L. 2002. The world of social entrepreneur. The International Journal of Public Sector Management 15 (5), 412–431.
W a t s o n P. 2013. Catastrophic citizenship and discourses of disguise: aspects of health care change in Poland. In P. Watson (ed.), Health care reform and globalisation. The US, China and Europe in comparative perspective. Abingdon, 118–139.
W ł o d a r c z y k C. 2000. Podstawowa opieka zdrowotna jako kategoria polityki zdrowotnej. In A. Czupryna, S. Poździoch, A. Ryś, C. W. Włodarczyk (eds.), Zdrowie publiczne. Wybrane zagadnienia, t. I, Kraków, 213–228.
How to Cite
Wierciński, H. (2019). Are Polish Primary Care Practitioners Social Entrepreneurs?. Ethnologia Polona, 40, 169-186. Retrieved from