Forces to Be Reckoned With: Countervailing Powers and Physician Emotional Distress During COVID-19

Details

• Journal Article:
  Journal of Health and Social Behavior
• Personal Author:
  Jenkins, Tania M. ; Buchbinder, Liza ; Buchbinder, Mara
• Description:
  The "countervailing powers" framework conceptualizes health care as an arena for power contests among key stakeholders, drawing attention to the moves, countermoves, and alliances that have challenged physicians' dominance since the 1970s. Here, we focus on one of the lesser known micro-level consequences of such forces for physicians: emotional distress. We draw on 145 interviews with frontline physicians across four U.S. cities during the COVID-19 pandemic to trace physicians' experiences with three countervailing forces: the state, health care organizations, and patients. We find that threats to physician dominance eroded physicians' sense of mastery (perceived personal control) at work, thereby prompting emotional distress, including anger and moral conflict. Conversely, in certain cases, acts of resistance may have helped increase mastery, thus moderating distress. Our findings advance the countervailing powers framework by elucidating some of the micro-level, personal consequences of macro-level power struggles and offer practical implications for understanding contemporary threats to physician dominance.
• Subjects:
  COVID-19 Mental Health Occupational Health Safety Stress, Psychological
• Keywords:
  Author Keywords: Countervailing Powers; Distress; Mastery; Physician Dominance; Stress Physicians; Emotional Stress; COVID-19; Occupational Psychology; Job Stress; Mental Health;
• Source:
  J Health Soc Behav 2025 Dec; 66(4):531-546
• ISSN:
  0022-1465
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  North Carolina ; California ; Atlanta Region [OSHA] ; San Francisco Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  16 pdf pages
• Volume:
  66
• Issue:
  4
• NIOSHTIC Number:
  nn:20071211
• Contact Point Address:
  Tania M. Jenkins, The Department of Sociology, UNC-CH, 155 Pauli Murray Hall, CB #3210, Chapel Hill, NC 27599-3210, USA
• Email:
  tania.jenkins@unc.edu
• Federal Fiscal Year:
  2026
• Performing Organization:
  University of North Carolina Chapel Hill
• Peer Reviewed:
  True
• Start Date:
  20210901
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1c529d73efa62c81ed795805f8c9e20cb315b5f69629df8e816667bad1896ce25bdb4fc76ddd3af2f2f34791b91261e62543181d3f4de830729bcb2dca6ee840
• Download URL:
  https://stacks.cdc.gov/view/cdc/258690/cdc_258690_DS1.pdf
• File Type:
  [PDF - 203.73 KB ]