History Of Patient Doctor Relationships(social aspects)

By: Ahmed Albehairy

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).

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.

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.

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.

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).

THANK YOU