Institutional Health Voids, Learning Myopia, and Counter-Knowledge: Unveiling Blind Spots in Healthcare Decision-Making
Published Online: Jun 25, 2025
Page range: 105 - 119
Received: Apr 06, 2025
Accepted: May 25, 2025
DOI: https://doi.org/10.2478/mdke-2025-0007
Keywords
© 2025 Juan-Gabriel CEGARRA-NAVARRO et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1.

Blind spots in the Spanish national healthcare system
Actors | Blind spots | References |
---|---|---|
Users | Excessive delays in care delivery, with waiting times frequently surpassing two weeks. Shortages of medical professionals in both primary and hospital care, largely stemming from politically driven selection and hiring processes. Overburdened emergency services and an increasingly burdensome medication co-payment scheme. Structural and systemic inefficiencies affect the overall functioning of the healthcare system. Limited awareness and enforcement of data privacy, resulting in obstacles to accessing personal health information. |
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Doctors and Nurses | Low public sector salaries have led to significant dual employment, with many healthcare professionals working simultaneously in both public and private sectors. An aging medical workforce, combined with precarious employment conditions for younger doctors, often limited to temporary contracts, has resulted in high staff turnover. Diminished patient engagement, with reduced time allocated per patient, negatively affects communication and the speed and accuracy of diagnoses. Inadequate data privacy awareness, limiting effective protection and management of personal health information. |
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Administrators | The duplication of medical records and documentation contributes to poor coordination between primary care and specialized services. Poor management of public hospitals and lack of resources. Existence of individual interests. Inadequate attention to organization culture. Lack of awareness about patients’ data protection. |
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Policymakers | Politicizing the process. General complacency. Poor essential infrastructure and public works. Weak legal frameworks. |
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Institutional health voids, weak signals, and corresponding counter knowledge
Institutional Health Voids (IHVs) | Weak signals | Counter-knowledge |
---|---|---|
Inter-institutional coordination | Cost-based service | Rumors regarding healthcare quality |
Public financing | Unclear procedures | Confusion regarding the final price of medications |
Social power systems | Discrepancy based on community-affiliation | Impression of bias toward political or economic interests |