Paper short abstract:

This paper explore how the staff at the admission desk of a public hospital talk about their job as giving real or fake appointments. The idiom used to refer to this task reveals aspects of healthcare that go beyond access and entitlement and it shows how health-related deservingness is reckoned.

Paper long abstract:

In this paper I analyze the practices and discourses of administrative staff at the admission desk in one public primary healthcare centre in Madrid (Spain). At the admission desk, different dynamics take place to allocate appointments with doctors and nurses, which in this context are scarce resources. Frequently, administrative staff refer to the appointments that patients ask for with an idiom of real versus fake appointments, depending of their own interpretations about the way people ask for the appointments. I aim to disentangle the multiple factors that discursively construct some appointments as real and others as fake. Competing ideas about the professional role either as gatekeepers or facilitators of healthcare provisions play a fundamental role in the formation of this idiom of real versus fake. Similarly, workload and the relationships with other members of the healthcare staff modulate the way admission staff talk about their work. Beyond issues of access and entitlements, the idiom of real versus fakes appointments reveals the different ways administrative staff reckon health-related deservingness of the potential patients at the healthcare centre.