Understanding the moderating role of the professional service encounter in consumer perceptions of health service risks

Abstract

Correct understanding of the risks of treatments is essential for consumers of health services. Yet, existing research has not examined how consumers understand risk in mixed-market health service environments, where private sector firms operate alongside established public sector providers, such as is the case in the UK. As the range and complexity of private sector health services increases, there remains uncertainty about how individuals will perceive, and respond to, the risks involved in using such services. In this research, I examine the role of the professional service encounter as a moderator of risk perception. I manipulate two key variables in the service encounter: emotional labour and professional role. Emotional labour, and the perception by the consumer of affect arising from the use of emotional labour, is a key technique used by service employees to create empathy and increase consumer engagement. Professional role refers to the varying levels of credence attached by consumers to health professionals representing either the private or public sector. My hypotheses are that risk perception will be more strongly reduced by deep acting than surface acting (H1)and that high credence professional roles will more strongly reduce risk perception than low credence ones (H2). Through interaction effects, deep acting is hypothesised to have a greater impact on reducing the perception of risk where the professional role is private sector than where it is public sector (H3). Data on consumers' worry levels is also gathered, and it is hypothesised that health consumers would have high levels of pathological worry (H4), and that worry is positively related to gender (H5) and education level (H6). Finally, general risk perception and risk taking data are gathered, and I hypothesise that health risk taking would be negatively related to health risk perception (H7). These hypotheses are tested using online video stimuli with a sample (n=285) of health service consumers. Findings suggest that the consumer perception of risk is moderated not by emotional labour on its own, but by the interaction effects between emotional labour and professional role. Whilst surface acting reduces risk perception when the doctor holds a private sector role, the opposite is the case when the doctor is from the NHS. This suggests that the role of emotional labour is dependant on the professional context in which the health service is offered, and the relative position and status of the health service consumer. Furthermore, it was found that there was little evidence of pathological worry amongst health service consumers. This supports the concept that the ‘worried well’ are a reflection of the increased awareness of psycho-social conditions amongst health service consumers, and the challenges this provides to the professional status of health professionals. The implications of this research suggest that a combination of higher consumer demands for health services and the lack of political will to reform the NHS system will lead to a larger ‘grey market’ for health services in the UK, where private and public services are used together by consumers to meet their changing needs.