A MEDICAL PARADIGM SHIFT AMONG PHYSICIANS: ACCEPTANCE OF HEALTH EDUCATION AND WELLNESS.

Abstract

The purpose of the study was to determine whether it was possible to predict the socio-demographic characteristics of physicians who adopt a new paradigm in medicine, wellness. A major objective of the research was to test the "marginal man" hypothesis. The literature suggested that there are at least three types of innovations: technological, organizational, and paradigmatic. Literature on the diffusion of innovations in medicine showed that high status physicians adopt technical innovations; more marginal, particularly young physicians and those of a liberal political orientation, most often adopt organizational innovations. Few studies dealing with paradigmatic innovations were found. Historical evidence supports the notion that family practitioners might be more accepting of the new paradigm. Physicians in Tucson, Arizona were surveyed concerning their attitudes and practices in the areas of health education and wellness, examples of the new paradigm in medicine. They were also asked about hospital-based health education services and competition between physicians and hospitals, examples of organizational innovation. The analyses revealed that family practitioners, women and government physicians were most supportive of wellness, affirming the research hypothesis and the "marginal man" hypothesis. The analysis also suggested that younger and more liberal physicians were more favorably disposed toward hospital involvement in health education. Liberal physicians were also not concerned about competition in health education service. These findings are similar to those found by other researchers of organizational innovations in medical care. Several methodological problems were noted, which render the findings suggestive rather than conclusive. The findings do suggest, however, that physician resistance to wellness will continue because of a medical paradigm conflict.