This document outlines the history of different approaches to conceptualizing patient-doctor relationships from a social perspective. It discusses (1) Talcott Parsons' initial formulation from 1950-1978 which viewed illness as a transitional sick role; (2) criticisms of this approach and alternative views proposed by Szasz and Hollander focusing on acute vs. chronic illness; (3) perspectives on professionalization and socialization in the 1960s; (4) issues of professional power and autonomy in medicine; (5) Marxist and feminist critiques from the 1970s-1980s regarding medical industrial complex and gender dynamics; (6) economic approaches in the 1980s conceptualizing the relationship as a contract; and (7) focus on communication and

1. History Of Patient Doctor Relationships
(social aspects)
By: Ahmed Albehairy

2. Approach to Patient Doctor Relationships
I- Parsonian Formulation( 1950-1958-1978)
- 1st social scientist to theorize Patient Doctor
Relationships.
- sick role, illness is a transitional state ( deviance).

3. Approach to Patient Doctor
Relationships( 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.

4. Approach to Patient Doctor
Relationships( cont.)
Critics of Parsonian Formulation:
- Socialization and doctor role expectation, not
universal.
- Affective neutrality?.
- Only discuss acute illness.
- Mainly discussing family physicians.

5. Approach to Patient Doctor
Relationships( 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.

6. II-Professionalization & Socializatio(1961)
- Socialization and intercultural variation.
- Affectionism vs. dehumanization.
- Professional identity vs. social identity.

7. III- Professional Power & Autonomy
- Mal function is not only a social deviance.
- Defense of autonomy.
- Insurance.
- Institutions ( vehicle vs human).

8. 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??

9. 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.

10. 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).

11. THANK YOU