History Of Patient Doctor Relationships (social aspects) By: Ahmed Albehairy
Approach to Patient Doctor RelationshipsI- Parsonian Formulation( 1950-1958-1978)- 1st social scientist to theorize Patient Doctor Relationships.- sick role, illness is a transitional state ( deviance).
Approach to Patient DoctorRelationships( cont.)Parsonian Formulation:Parson saw 4 norms governing the functional sick role:- The individual is not responsible for their illness.- Exemption of the sick from normal obligation till they are well.- Illness is undesirable.- The ill should seek professional help.
Approach to Patient DoctorRelationships( cont.)Critics of Parsonian Formulation:- Socialization and doctor role expectation, not universal.- Affective neutrality?.- Only discuss acute illness.- Mainly discussing family physicians.
Approach to Patient DoctorRelationships( cont.)Critics of Parsonian Formulation:Szas and Hollander:- Acute illness :P- passive, D-assertive- Chronic illness: P-cooperative, D- guidance.- Culture aspects of sick role.
II-Professionalization & Socializatio(1961) - Socialization and intercultural variation. - Affectionism vs. dehumanization. - Professional identity vs. social identity.
III- Professional Power & Autonomy- Mal function is not only a social deviance.- Defense of autonomy.- Insurance.- Institutions ( vehicle vs human).
IV-Marxist & Feminist (1972-1985)- Medical-industrial complex, capitalism, profit maximization, constraints physician, and decision making.- Physician are both agent and victim of capitalist exploitation.- Proletariazation / deprofessionalization.- Male physician- female patient relationship.- Women ?? Congenitally weak,- Female doctors and specialties??
V- Economic Approach:(1980-1990)- Contract between P/D.- P- maximizing consumption of health.- D- maximizing income.- Health insurance.- Define illness leads to arguing the physician finance.- Induce demands vs. true needs.
VI- Communication & Outcome( 1950-1993) - Improve physician skill communication. - Increase the quality of caring. - Investigate the conflictual P/D relationship. - Bargain over the treatment. - Kinds of interaction that improve patient satisfaction( make decision, code of ethics, patient satisfaction and kind of medical care).