Unmasking the Power Paradox of Patient-Centred Care in Chinese community health

Date:

16 October 2025, Thursday

Time:

2.00pm – 3.00pm Singapore [GMT +8]

Location:

Seminar Room 2, Level 8
Tahir Foundation Building (MD1)
National University of Singapore
12 Science Drive 2, Singapore 117549

Abstract:

This presentation examines a critical paradox at the heart of modern healthcare reform: why does ‘patient-centred care’ (PCC), a paradigm designed to empower patients and dismantle traditional hierarchies, so frequently fall short in practice? Drawing on a year-long ethnographic study within a Chinese community health centre, incorporating non-participant observations and semi-structured interviews with doctors and hypertensive patients, this research utilises Steven Lukes’ three-dimensional theory of power to uncover the mechanisms behind this failure. The findings reveal that the empowering rhetoric of PCC often obscures a reality in which existing power structures are not challenged but are, in fact, subtly reinforced. The analysis identifies three key paradoxical mechanisms: (1) Protective Authority: Doctors well-intentioned efforts to protect patients manifest as directive, paternalistic behaviours that ultimately limit patient agency and foster dependency; (2) Framing Authority: Organisational agendas and policies, which prioritise efficiency and standardisation, structurally constrain consultations, narrowing the scope for any genuine, patient-led dialogue; and (3) Internalised Compliance: patients often internalise the role of the ‘good’, compliant patient, perceiving deference to medical authority not as a limitation on their autonomy, but as an integral part of their identity and a contributor to effective care. This study argues that the implementation of PCC in China is shaped by a deeper socio-political context in which its rhetorical adoption serves to maintain the status quo rather than disrupt it. The presentation concludes that without addressing these fundamental power dynamics, PCC risks functioning merely as a legitimising ideology for existing hierarchies.

Speaker:

Dr Bo Li
Postdoctoral Fellow
Department of Applied Social Sciences
The Hong Kong Polytechnic University

Dr Bo Li is a Distinguished Postdoctoral Fellow in the Department of Applied Social Sciences at The Hong Kong Polytechnic University, where he also completed his PhD in 2024. His research is situated at the intersection of public health and sociology, employing key sociological frameworks (e.g. power, structuration, agency) to investigate pressing population health challenges such as hypertension management and smoking cessation. His award-winning doctoral thesis applied social power theories to offer an in-depth analysis of community nursing practices in China. Dr Li’s work has been published in leading international journals, including Social Science & Medicine, Health Sociology Review, Nursing Inquiry, Public Health Nursing, and Journal of Nursing Management.