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Towards a systemic understanding of a hospital waiting list

J.L. Foote (Institute of Environmental Science and Research Limited, Christchurch, New Zealand)
N.H. North (School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand)
D.J. Houston (Institute of Technology and Engineering, College of Sciences, Massey University, Palmerston North, New Zealand)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 1 June 2004



Hospital waiting lists are a feature of publicly funded health services that result when demand appears to exceed supply. While much has been written about surgical waiting lists, little is known about the dynamics of radiology waiting lists, which is surprising given that rational treatment, and indeed the medical profession's claim to expertise, rests on establishing a diagnosis. This paper reports the findings of a case study of a problematic ultrasound waiting list. In particular, this paper highlights how the management of the ultrasound waiting list served to subordinate the needs of waiting patients and their general practitioners to the interests and values of radiologists. Radiologist concern to protect specialist expertise from encroachment by outpatient clinicians and sonographers is implicated in the growth of the ultrasound waiting list. It is argued that an adequate understanding of ultrasound waiting lists depends on grasping how radiologists are successful in structuring problems of access in ways that enhance radiologist control over ultrasound imaging. The case study reported helps to shed light on why increasing funding to clear waiting lists proves ineffective.



Foote, J.L., North, N.H. and Houston, D.J. (2004), "Towards a systemic understanding of a hospital waiting list", Journal of Health Organization and Management, Vol. 18 No. 3, pp. 140-154.



Emerald Group Publishing Limited

Copyright © 2004, Emerald Group Publishing Limited

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