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Much of the body of literature analysing the gig economy focuses on its exploitation of low-wage workers and its role in increasing precarious work. This chapter approaches the topic from a different angle, focussing on the contribution of the gig economy to the declining power of the medical profession. As well as facilitating and promulgating contingent work in healthcare, the gig economy disaggregates medical work into isolated on-demand micro-tasks on digital platforms. This has implications for the status and power of the medical profession, the doctor–patient relationship, and inter-professional boundaries in healthcare. The mechanisms through which these dynamics unfold, as well as the inter-related factors that support the transformations in the allocation and content of medical work, are discussed. These include the implications of heightened transparency of medical work resulting from unbundling of jobs, commodification of medical professionals, and platform-based vulnerabilities such as rating systems that impact doctor–patient relationships. Closure theory is drawn on to illuminate the dynamics of the transformation in professional boundaries and the arising conflict that it entails for the healthcare workforce at different levels. The conflict is theorised as an insidious exercise of closure by allied health professionals on the remit of the medical profession, which challenges remuneration, authority, and other exclusionary benefits traditionally accrued to the medical profession.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

The COVID-19 pandemic, and the responses to it that were required from frontline healthcare providers and others working in healthcare settings including environmental, clerical, and security staff, has challenged our healthcare systems in unprecedented ways. The threats to the financial, physical, and psychological well-being of healthcare professionals – many of whom entered the field due at least in part to a deep commitment to caring for and helping others – will have profound and long-lasting personal and professional impacts. Early in the pandemic response, healthcare professionals knew little about the risks they, their patients, and their loved ones faced from COVID-19 as they operated under crisis standards of care and without adequate supplies of personal protective equipment. As the pandemic response progressed, the lack of clear, science-based guidance, and the politicization of the pandemic presented new medical, ethical, and moral dilemmas. New psychological support mechanisms, including crisis counseling and evidence-based interventions, are needed for all workers in healthcare settings, regardless of their job role.

Purpose: Significant structural changes are currently occurring in the Indian labour sector. Artificial intelligence (AI) and other emerging technologies are redefining the activities and skill requirements for various jobs in the healthcare sector. These adjustments have been accelerated by the economic crisis brought on by COVID-19, along with other considerations.

Need for the Study: Skills shortages, job transitions, and the deployment of AI at the company level are the three main challenges confronting the Indian labour market. This chapter aims to discuss policy alternatives to address a rising need for health workers and provide an overview of changes to the healthcare sector’s labour market.

Methodology: A review of the available literature was conducted to determine the causes of the widening skill gap despite a vibrant and prodigious young population. The background of the sustainable labour market is examined in this chapter, with a focus on workforce migration and mobility.

Findings: This chapter gives a comparative review of recent policy papers and evidence, as well as estimates of the health workforce and present Indian datasets. Furthermore, it highlights how important it is for all people concerned to invest in today’s workforce to close the skill gap and create better future opportunities.

Practical Implications: This chapter’s findings imply a severe shortage of human intellectual capital in India and a need to bridge this gap in the Indian labour market.

Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of these practices depends on policy-makers’ capacity to involve professionals dispersed in the ecosystem, and who are unaccustomed to cooperating. Our case study investigates the institutional work pursued by the Lombardy Region to stimulate a Health Technology Assessment (HTA) program.

This chapter is based on a longitudinal case study of institutional change linked with a HTA program in the Lombardy Region. The HTA program initiatives were implemented during the 2009–2012 period. The case study is based on triangulating data from archival data, contents of the assessment forms and interviews with regional staff and experts.

The Lombardy Region implemented two distinct strategies, with mixed results. A strategy that was based on the formalization of the HTA program in a legislative direct through educational efforts did not obtain the commitment of the key actors in the relevant ecosystem. Subsequently, the Region implemented an ‘institutional work’ design strategy that included a combination of political, cultural, technical and structural work. This strategy stimulated local HTA experiments that might be used in the future to legitimize the full diffusion of the new practice in the ecosystem.

This study highlights a viable strategy of change that policy-makers can use to manage processes of institutional change in a professional ecosystem. The ‘institutional work’ strategy can support the establishment of new practices that incorporate the logic of cost-opportunity, which might rationalize the use of resources and improve investment decisions.

This project examines how queer and trans zines have complicated the notion of traditional patient narratives and provides insight into the issues that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) populations face when accessing healthcare information and resources. Historically, information about queer and trans identities has been suppressed in the United States, reflecting dominant social values that pathologize queer identities. Using health-related zines housed at the Queer Zine Archive Project as a case study, this project investigates how queer and trans zines about healthcare have resisted these homophobic and transphobic ideologies. The analysis reveals that queer and trans zinesters use their feelings of impatience with the medical industry to fuel communal solutions to accessing and providing health care information.

Human evolution has witnessed the highest level of metamorphism overages. COVID-19 alarmed us when we were unceasingly running toward monetary benefits and money, the significance of health. That initiated the thought process of improvising the health and healthcare infrastructure, leading to the birth of the health cooperative as a reform. During the state of COVID services, operations of the hospital were unreachable due to the unavailability of doctors, facilities, hiked charges, and lack of insurance coverage made people disbelieve in the system. Many social activists propose the idea of healthcare cooperatives to foster healthcare needs. The study guides us to understand the roles of healthcare cooperatives like the establishment of service facilities, modernisation of existing facilities, expansion to various topographical locations, and healthcare education to the general public, repair, and renovate the instrumentation in the medical field. The study also finds the ways and means of self-sustainability of health cooperatives with dependency on government financial support during the initial take-off. The benefits of cooperatives contributing to the NDHM and supporting the development of healthcare infrastructure in rural areas. The study enables us to find the factors that healthcare cooperatives need to consider for providing the right benefit to the citizens and factors for the self-sustained and self-resilient mode of seamless operation. The study has two different data collecting instruments, one to collect the data from the public and other from healthcare professionals. The result of the study reveals the mechanisms through which healthcare cooperatives can provide well-structured healthcare support to the nation.