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Part One: Hidden Value
Chapter 1 Social Work and the Interpersonal Economy
Chapter 2 Service Delivery and the Value of Practice
Chapter 3 Relationships: The History of an Idea in Social Work
Part Two: Statutory Social Work and Well-being
Chapter 4 Constructive Social Work in Public Services
Chapter 5 Independence and Well-being in Social Care
Chapter 6 Community, Cohesion, Diversity and Deprivation
Part Three: Social Reproduction
Chapter 7 Accountability and Community Participation
Chapter 8 Harm, Stigma and Exclusion in Communities
Chapter 9 Conclusions: Social Reproduction in a Service Economy
About the Author
Bill Jordan worked in the social services for 20 years, as a front-line practitioner, andhas since done research and consultancy for several agencies. He has written some 25books, on social work, social and political theory, migration, social policy and politicaleconomy. He has held visiting chairs in Germany, the Netherlands, Denmark, Slovakia,Hungary, the Czech Republic and Australia, and is currently Professor of Social Policyat Plymouth and Huddersﬁeld Universities, and Reader in Social Policy at LondonMetropolitan University.
I would like to thank Nigel Parton for helpful comments on the ﬁrst draft of this book,and Gordon Jack for stimulating conversations which pointed me towards some of itskey themes.
I also appreciated and learned from working with Martyn Rogers, Linus Whitton and
other colleagues, and with the members of a focus group on social care, whom I thankfor giving their permission to quote from their discussions.
I am especially grateful to Rachel Arnold for typing the manuscript of the book very
efﬁciently and quickly, and for insights about several aspects of the subject.
Introduction: The Value
of Social Work
From a high point in the early 1970s, when social work seemed to be the rising starof the human service professions, social workers have experienced a decline in publicesteem. Practitioners feel devalued by the media and politicians, even when they arewell appreciated by those who use their services. Their expertise and effectiveness areconstantly questioned, and they are blamed for notorious scandals, especially overabused children.
This book analyses the largely overlooked value of social work, and shows how it
could be increased, and made more evident to sceptics. I shall argue that theprofession itself has fallen into many traps in response to criticism, and hasunderplayed its strengths. This is because it has accepted a false standard by which tomeasure its value to service users and society.
In professions like medicine, teaching and clinical psychology, the value of
practitioners’ work is usually measured in terms of the restoration of patients tohealthy functioning, the knowledge and skill imparted, and the relief of burdensomesymptoms.
This in turn is translated into higher productivity, and hence income, by those who
beneﬁt from these services. The outcomes show up in Gross National Product (GNP)– doctors, teachers and psychologists can demonstrate the value realised by their workin hard material terms.
But there is another whole contribution that these services make which is not always
recorded or recognised. Good health care, school experiences and therapy makepeople feel good
. Even if they are only partially cured, they pass few exams, and arestill slightly screwed up, feeling better about themselves and their lives is of real valueto them.
This added value, on top of the technical expertise which contributes to material
improvement, does not show up in national accounts, but it is real and substantial.
Social work contributes to both these kinds of value. Practitioners do protect
children, keep families together, maintain old people in their homes and help in therecovery of those who abuse drugs and alcohol. They also play a part in enablingpeople with disabilities and mental illnesses to be included in the economy and society.
But, perhaps more than the other human services professions, their work involves aform of practice which aims to get people to feel better about themselves. This is thevalue of social work which will be emphasised in this book.
Sceptics will, of course, be dismissive of this ‘feel-good factor’ – social workers as
cheerleaders and entertainers – but they should not be. This is because (at last) thevalue of feeling good about life is being recognised as a fundamental goal ofgovernment policies, and of the human services. Politicians now deploy the terms‘well-being’ and ‘happiness’ as buzzwords, and seek advantage for their parties bytrying to capture the ground of positive feelings.
Surprisingly, the lead in this re-valuation of emotions and relationships is being
taken by economists, notoriously the most hard-nosed of the social scientiﬁccommunity. Modern economics has gained predominance in this community becauseof its ability to explain and predict from mathematical models, and hence to informcommercial and government decisions. By excluding nebulous human factors such asemotions and relationships from the vast bulk of its analysis, economics is able toconstruct a working model of how individual choices translate into a global system ofproduction, trade and governance.
The basis for this model is that, whatever people may happen to be feeling about
themselves and each other, they will earn and spend in ways which allow them toconsume bundles of goods and services that maximise their ‘utility’. This means that,however they choose (between income and leisure, spending or saving, Orange oriPods) they will make the best of their resources. So, according to the economic modelwhich now underpins almost all present societies, and the global system of productionand trade, we can rely on money and prices as reliable guides to well-being, becausepeople will earn and spend in the ways that make them happiest.
Now leading economists (especially in the USA and UK) are drawing on psychologi-
cal evidence from all over the world which rebuts this assumption. There is no reliablecorrelation between a country’s national income per head and the average satisfactionof its population with the quality of their lives (Kahneman et al., 1999; Helliwell, 2003;Frey and Stutzer, 2002). Some rather poor countries, such as Ghana, have citizens whoassess their overall happiness almost as highly as the inhabitants of afﬂuent countries.
Some with middle-ranking levels of national income per head, such as Malta andUruguay, are also high in league tables of well-being (BBC Radio 4, 2006a). Althoughrich people in any country tend to be happier than poor ones, the most importantcomponents of well-being are health, close relationships, being active in a faith orcommunity, satisfying work and trust in fellow-citizens. Not the latest fashion items orelectronic wizardry.
This survey evidence conﬁrms what most social workers see every day in their
practice. People’s unhappiness is far more connected to their physical and mentalhealth, and their relationships with others, than to their material circumstances. Whathurts about being poor is not so much the absence of comforts and luxuries, but thestigma of ofﬁcial surveillance, the contempt of mainstream citizens, the exclusion from
Introduction: The Value of Social Work
civil associations, and the damage to personal relations. Survival strategies are stressfulbecause they have to be pursued against the current of society’s complacentassumptions about its own integrity and deservingness.
But social workers never expected these realities to be recognised by economists, of
all people. It will come as a surprise to read the soul-searching and self-criticism ofleading economic theorists like Richard Layard (2005: i) who calls for a new approachto public policy which promotes the common good, and for ‘a shift to a newperspective where people’s feelings are paramount’. So will the widespread mediaacclaim for Avner Offer’s (2006) economic history of ‘self-control and well-being inBritain and the United States’, which laments the decay of commitment and mutualityin the face of afﬂuence and individualism. And these best-selling texts are comple-mented by collections of equally critical reﬂection on their fundamental assumptionsby top economists in edited volumes (Bruni and Porta, 2005; Huppert, Baylis andKeverne, 2005).
So the time is right for a re-assertion of the value of social work, not in terms that
echo the demands of accountants, managers and government ministers, but in its ownterms. Economists are calling for other social scientists and human service profes-sionals to complement their new insights and shift public policy towards the prioritiesof well-being and quality of life (Layard, 2005: 145–7). But to do this, social work mustﬁrst recognise its own potential worth and contribution.
Already, I imagine, two objections to my agenda are springing to the reader’s mind.
First, the return to a justiﬁcation of social work activity in terms of relationships andfeelings seems to throw away hard-won gains in effectiveness, rigour and value-for-money. The past 15 years have seen a major shift towards evidence-based practice inthe profession (and in health care too) along with a style of management whichdemands such evidence before a project or priority is funded.
The advocates for these approaches (Sheldon, 2001; Macdonald and Sheldon, 2000)
would argue that, although they are resisted by much of the profession, they havepurged it of many of its past illusions and errors. Social work was its own worst enemyduring the period of its rapid expansion in the 1970s, because its claims were bothvague and grandiose. The social work which has emerged from recent waves ofreform and modernisation as well as the redesign of training, is leaner and morecompetent, street-wise about how to gain political endorsement, and better able toengage with other human service professions.
However, social work is also tied into a particular approach to governance and
policy, derived ﬁrst from Margaret Thatcher’s neo-liberal version of public administra-tion, and then Tony Blair’s New Labour reformism. Under the latter regime ofmicro-management, government has set very detailed targets and outcomes, andspeciﬁed quality in terms of statistical returns. This version of value for taxpayers’
money rests on a set of assumptions and principles about the social order which arecoming under question. The well-being agenda reﬂects the beginning of a shift awayfrom individualism, choice, markets and mobility which have driven the transformationof citizenship and public life in the past 25 years (Jordan, 2004, 2006a, Part II).
For social work to be seen to be indissolubly linked with the Third Way agenda
might be very damaging in the medium to long term. Already there are strong signsthat the consensus of the late 1990s is breaking up, and new political forces are beingmobilised. Social work’s somewhat contorted and strained efforts to present itself asfully in line with New Labour’s modernisation programme will look silly if Tony Blair’sproject continues to wane.
Above all, the future seems to lie in some new combination of environmental
awareness, a revival of respect and mutuality amid ethnic diversity, and a convincingversion of our collective quality of life (both globally and nationally). In the face ofthese challenges, the emphasis on individual consumption and self-expression, and thereliance on big business to deliver personal fulﬁlment, look dated. In the ﬁrst sphere,New Labour is beginning to sound like stale news; in the second it seems rather seedy,or even corrupt.
This is where David Cameron has displayed considerable gifts as a politician,
capturing the new agendas with a series of eye-catching speeches. Even if the claimto this political ground by a party which pioneered individualism, choice and greedseems implausible, Cameron is shifting the debate to a less explored territory. Aboveall, he has reintroduced many of the themes in which an older style of social workseems more relevant.
In a speech on 22 May 2006, in Hertfordshire he linked the different aspects of his
It’s time we admitted that there’s more to life than money, and it’s time we focusednot on GDP (Gross Domestic Product) but on GWB – General Well-being . . . It isabout the beauty of our surroundings, the quality of our culture and above all thestrength of our relationships. There is a deep satisfaction which comes frombelonging to some one and some place. There comes a point when you can’t keepon choosing and have to commit.
These themes resonate with social work’s concerns about quality of life rather thanmaterial consumption or the work ethic. They also contrast with New Labour’semphasis on individual self-responsibility. The government’s Green Paper: Our Visionof the Future of Social Care for Adults in England, Independence, Well-being andChoice
(DoH, 2005) linked life-quality with self-sufﬁciency and mobility betweenoptions. Cameron cleverly detached well-being from those associations, and chal-lenged the government (and the human service professions) to think again. Even if thiswas political opportunism, it has moved the debate about society’s priorities forward.
Cameron’s critics, and those suspicious of any such agenda for social work, will
point to the vagueness in his rhetoric. These ideas imply no particular policy agenda
Introduction: The Value of Social Work
or resource allocation. In social work, the drift back into fuzzy concepts like‘relationships’ and ‘feelings’ threatens a loss of intellectual rigour and scientiﬁcedge.
In this book, I shall rebut this accusation. The value of social work can never be
adequately represented in terms of gains in independence, choice or economicfunctioning. It will always undersell itself unless it can deﬁne and assert its value in theemotional, social and communal spheres of life. But this does not imply cosiness orwoolliness. The fact that economists are seeking to analyse these same phenomenaindicates a clear opportunity to treat these dimensions of experience with the sameclarity of explanation as the material sphere.
This leads to the second objection (also implicit in the adoption of these themes by
David Cameron), that the links between nature’s beauty, our cultural legacy and thebonds of emotion and belonging, are all inescapably rural, backward-looking andconservative in their ambience. Is this not Old Tory territory – the stuff of writers likeMichael Oakeshott, and the One Nation tradition of Disraeli, Churchill and HaroldMacmillan (Kettle, 2006)?
Worse still, is not the idea of social work as inducing warm feelings a clear instance
of its oiling the wheels of injustice and exploitation, making poor, excluded andoppressed people content with their lot? Is this not a prescription of Prozac orMogadon for society – social work as tranquiliser or sleeping pill?
Again, I shall seek to argue against this conclusion in this book. What makes people
feel good about themselves is complex. People assess their overall happiness in relationto their life-projects, and their situation in society. They are mostly not content withpassivity and stagnation, and social work could not induce them to accept this fate ifit tried. Individuals may not all want to struggle for Aristotle’s ‘eudaimonia’ (fulldevelopment, of all their faculties) or Milton’s ‘strenuous liberty’, or to be Wor-dsworth’s ‘Happy Warrior’ (Nussbaum, 2005) but nor do they willingly embraceinjustice and marginalisation.
Indeed, the greater challenge for social workers is how they can shift themselves
and service users beyond present-day concerns with material consumption andinstrumental outcomes. In a culture of choice and self-expression, well-being demandsa balance in the form of emotional closeness, respect and collective solidarity. Theseare not inherently conservative values, rather the issue should be how to give them aradical new connection with the concepts of justice, inclusion and diversity.
Value and values
In the course of trying to clarify the value of social work, I shall also tackle some ofthe knotty problems in social work theory. One of the most longstanding is thequestion of how practitioners reconcile conﬂicts between the ‘subjective’ world oftheir client’s experiences, and the ‘objective’ demands of society (the law, regulations,guidance and procedures).
This issue becomes clearest in relation to protecting children from abuse, and using
compulsory power to protect others (or themselves) from people with acute mentalillnesses. Whole libraries are ﬁlled with books and articles on the ethics and practiceprinciples of these functions. Yet there is always something unﬁnished and unsatisfac-tory in the formulae which emerge from such analyses. Whether they favourrespecting people’s personal experiences and choices or enforcing society’s rules, theyseem to be missing the process by which good practice can dissolve their apparentcontradiction, and help those involved come to a resolution of their conﬂicts.
At the heart of these disputes in social work theory is the inescapable fact that
practitioners have an ethical duty to respect people’s individuality, yet also a legalresponsibility to enforce society’s standards (including the protection of persons andtheir property). What are called the profession’s ‘values’ feature both the fundamentalworth of each person who has contact with a service, and the duty to protect all fromavoidable harm. Confusingly, these values co-exist with commitments to ﬁght againstoppression and injustice in wider social relations (BASW, 2003).
One of the clearest recent accounts of these dilemmas is in Michael Sheppard’s
Social Exclusion and Social Work
(2006). He takes issue with subjectivists, relativistsand interpretivists who opt for service users’ rights to set their own agendas and asserttheir own values, where others’ vital interests are at stake. Sheppard arguespersuasively that there are sometimes objective standards of need and the preventionof harm in practice situations, and that these cannot be suspended or sidelined for thesake of greater understanding, empathy, therapy or creativeness.
But this does not entirely explain how the value of abusers, offenders or mentally
ill people is preserved, or their ‘values’ respected. Sheppard explains that socialworkers have a duty to negotiate with all parties as rational agents, but to overrulethose who cannot recognise or act upon the vital interest of others. The law andregulations deﬁne the responsibilities of citizens in terms of rationality, and the harmsto be avoided where possible. Social workers should seek to recognise both theexternal constraints on people, and the limitations of their internal resources, and thenengage with them as fully and ‘democratically’ as these allow (Sheppard, 2006:116–20).
But it is in the nature of this engagement that something is missing from Sheppard’s
analysis. While there are crucial decisions to be negotiated and made at the level ofrationality and the law, there is another whole dimension of the encounter betweenpersons. This concerns the value of each individual, and how this value is then broughtinto each human interaction, and either enhanced or diminished.
The value statement that ‘each individual is of equal worth’ is the fundamental
ethical principle, not just of social work, but also of liberal democracy. All the other‘values’ of the profession, and of our political system, follow from this ﬁrst one. Butthis is not simply a negative liberty, prohibiting social workers or others fromencroaching on a service user’s freedom and self-ownership. It also asserts that eachperson adds something to the collective value that makes up a society. How each
Introduction: The Value of Social Work
person does so is through their interactions with others, in various social units, fromfamilies to social movements and political parties. These interactions create extra value(though they can also diminish the value experienced by some participants, for examplethrough stigma, disrespect, unfairness or oppression). Each interaction (between twopeople or a group) is therefore like a small enterprise (a cooperative factory, a shop orservice) in which value is produced – but (like these) it may also exploit or cheat some‘workers’ or ‘customers’, or cause ‘pollution’ to some third parties.
The difference between the material economy producing goods, and the interper-
sonal economy producing feelings (including morale, team spirit and solidarity) andculture (ideas, images, science, art, music and drama) is that the latter producessomething intangible and difﬁcult to measure. But what the interpersonal economyproduces is real.
It determines our emotional state, it shapes our wider engagementswith the material economy and the formal systems of government, and it provides uswith both the resources
and the restraints
for our thoughts and actions. In otherwords, our social world is shaped and patterned by the interpersonal economy. Weuse material products and processes in the ways that our emotions and culturesenable. We interpret the formal organised world using the symbols and meanings wederive from the interpersonal one.
So the value of each human being is in their membership of the interpersonal
economy, and the fact that (whether we or they like it or not) they share in the givingand receiving of value through these interactions. In this way, they also share in thecreation and exchange of emotions and cultural resources. In so far as we are allmembers of this interpersonal system, our fates are inextricably linked with eachother’s. We can enhance or damage each other, but we cannot evade our mutualinﬂuences, or escape from the web of feelings and ideas that we produce through allour encounters.
The subjectivist, interpretivist and even relativist schools of social work theory are
basically asserting this fundamental truth. Service user ‘values’ enter into theirengagements with practitioners, and inﬂuence their encounters. They have to berespected, because they are part of the person, and contribute to what is producedin their interactions. I shall discuss this in more detail in relation to ‘constructionist’views of practice (Parton and O’Byrne, 2000).
Sheppard is also very critical of others (such as certain feminist theorists) who assert
the special validity of a particular standpoint (such as that of disadvantaged women)in negotiations about needs (2006: 126–7). But here the point is that the level ofrational-legal discussion between social workers and service users is only onedimension of practice. At the other (interpersonal) level, speciﬁc standpoints such asthese do have special validity, and can be taken into account in what is constructed byencounters between practitioners and service users.
Sheppard also criticises Marxist theorists for focusing on social structures, arguing
that this kind of intervention is inappropriate for social work (2006: 127–31). Again,this is not a fair criticism if what is being claimed is that the culture and institutions
of capitalism are often experienced by service users as oppressive, and that ideas andcollective action which resist that oppression are of potential value to thoseexperiencing those situations. If group and community work enable service users andmembers to generate the cultural resources to act together, to mobilise and organisearound their collective interests, and to challenge dominant ﬁrms’ rhetoric, orgovernment agencies’ agendas, then this is indeed a valid form of intervention.
The term ‘empowerment’ (which Sheppard criticises extensively) can stand for just
these practices. People such as refugees and asylum seekers, homeless people and theresidents of deprived districts are enabled to form movements, to challengestereotypes, and to debate with power holders. There is no guarantee that they willbe able to change structures, achieve redistribution of power, or shift others towardsgreater equality and justice. But the very act of coming together and pursuing theirown purposes allows them to gain new resources (interpersonal cultural goods) to usein other parts of their lives. I shall give examples of this in Part Three of the book.
In the present-day literature of social work, which takes much of its tone from
neo-liberal and Third Way political discourse, empowerment is seen primarily asgaining personal capacities, skills and competences, or accumulating ‘social capital’ inthe form of links with other individuals and groups. This is the kind of empowermentappropriate to a society in which individual self-realisation is the main project forcitizens, and the focus of positive government interventions.
A psychology of self-improvement pervades our culture (Rose, 1996) encouraged by
governments which see independence and self-responsibility as the primary qualitiesof the good citizen (Ellis and Rogers, 2004). If the interpersonal economy is central toindividual well-being, and to good social relations, then individualism, especially in itscompetitive rivalrous forms, is likely to be self-defeating (Layard, 2005). Only whensociety’s values reﬂect the value of relationships and a culture of sharing willwell-being be reliably increased, and social work play its full part in this process(Jordan, 2006a and b).
Themes and plan of the book
So the main theme of the book is to re-assert those aspects of social work practicewhich emphasise that relationships between people, and between the practitioner andthe service user, are central to professional activity. Although, as I shall show, thisdeﬁning feature of social work is still implicitly at the heart of theory and practice, andacknowledged as such by those who have contact with practitioners, it has beenlargely expunged from policy, guidance and management literature.
In Part One of the book, I shall explain the contribution of ‘interpersonal goods’ to
well-being, and how social work practice can help individuals and groups improve theirwell-being by explicit acknowledgement of this research-based ﬁnding (Chapter 1).
I shall then show how the value of social workers came to be deﬁned solely in terms
of the ability to deliver services (modelled as marketed products) to individuals whose
Introduction: The Value of Social Work
well-being was taken to lie in a choice of alternative suppliers, or as offering skilledinterventions to target and change speciﬁc behaviours, or as organisers of voluntaryagencies or volunteers, seen as embodying ‘community’. Using examples from servicesfor children and adults, I shall illustrate some of the negative consequences of thisregime (Chapter 2) and how it overlooks much of the value generated by the‘interpersonal economy’.
Next I shall trace the history of ideas about relationships in social work, and how
they have reﬂected the political context of each successive period in the profession’sdevelopment. I shall show how ideas of well-being and social justice have beeninﬂuenced by the political context over time, and social work’s understanding of itsmethods and tasks have changed accordingly. This narrative will be illustrated withexamples from the professional literature of each era (Chapter 3) which shows aremarkable continuity in valuing relationships and feelings, and rejecting a purelymaterialistic notion of equality, justice, membership and well-being.
The second main theme of the book is that practice which focuses on behavioural
change, protecting vulnerable individuals and meeting identiﬁed needs can bereconciled with the approach to well-being advocated in this book. What is beingpresented as an adequate analysis of the value of social work is as relevant forstatutory practice with disturbed and vulnerable people as it is for counselling orpreventive interventions. When David Cameron suggested that mainstream citizensshould ‘hug a hoodie’ (The Guardian
, 2006a) he was articulating the spirit of a socialwork which seeks the most marginal, angry and resistant members of society as itsclientele, and seeks to advance their inclusion.
This is why ‘constructive’ approaches to practice are not conﬁned to therapeutic or
voluntary services (Parton and O’Byrne, 2000; Gorman, Gregory, Hayles and Parton,2006). Using examples from child protection work and practice with offenders, I shallillustrate how the objective (harm prevention) and subjective (communicative, creative)aspects of everyday work can be reconciled (Chapter 4).
The goal of enabling service users to be independent and active participants in a
market economy is a very narrow interpretation of how to maximise their well-being.
It implies that services are one-off experiences, serially consumed, chosen from a menu(much as in a fast food outlet). Using research on older people and people withdisabilities, and their perceptions of their needs for services, I shall analyse theshortcomings of this approach, and the need to balance it with provision that enablescompanionship, sharing, collective experiences and participation (Chapter 5).
The New Labour government has always acknowledged the importance of
‘community’ and ‘cohesion’ but seen them as aspects of social relations which are tobe separate from the provision of social care and child protection. I shall argue thatthis is an artiﬁcial separation, and that social work and community work share manyof the same methods, principles and values in a diverse, multi-ethnic society (Chapter6). The analysis of well-being in terms of an ‘interpersonal economy’ is common toboth.
The third theme of the book is that relationships produce both interpersonal value
(feelings) and cultural goods (ideas, images and meanings). The organisation of theeconomy, society, and government all feed off these cultural goods, which people useto interpret our social world, and act effectively within it. Social work can contributeto the cultural resources of the most disadvantaged members of our communities.
For this approach to be most effective, services should become more answerable to
service users and community members. They should be the people who steer policyand practice; conversely, professionals should be more like coaches or consultants totheir clienteles, not agents of surveillance who report to managers, accountants andcourts, or impose top-down versions of a government-led social order (Chapter 7).
Professionals cannot evade the possibility of doing harm, and have a responsibility
to minimise this risk. This is what is implied by ethical codes and professionalcompetences. But it also involves addressing the risks of members of the communityoppressing or excluding others, or doing them direct harm, through bigotry, bullyingor exclusion. This will be analysed, with examples from youth and community work(Chapter 8).
Finally, I shall consider the relevance of social work to the kind of society which is
emerging in the afﬂuent countries in the new century. This consists of a serviceeconomy, with a diverse, mobile population, and many disadvantaged minorities. Ifthe new emphasis of government policy is to be more on well-being, and less on‘independence’ and ‘security’, then social work has a great deal to offer – but only ifit is true to its roots in the primacy of social relationships and emotional truth.
The re-emergence of immigration, integration and security as the main themes of
government policy threatens the gains in the well-being of disadvantaged groupswhich policies for inclusion and participation are beginning to promise. Anti-socialbehaviour and minority disaffection (including extreme violence) signal the non-viability of a mainstream social order based on individual self-responsibility, choice andswitching between options. The interpersonal economy provides a more fertile groundfor a long-term order in which diversity and freedom are reconciled with respect andbelonging (Chapter 9).
Self-medication with vaginal antifungal drugs: physicians’ experiences and women’s utilization patterns Sinikka Sihvoa,b, Riitta Ahonenc, Heli Mikanderc and Elina Hemminkia Sihvo S, Ahonen R, Mikander H and Hemminki E. Self-medication with vaginal antifungal drugs: physicians’ experiences and women’s utilization patterns. Family Practice 2000; 17: 145–149. Background. In man
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