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On the remarkable persistence of asymmetry in doctor/patient interaction: A critical review

Pilnick, Alison ; Dingwall, Robert

Social science & medicine (1982), 2011-04, Vol.72 (8), p.1374-1382 [Periódico revisado por pares]

Kidlington: Elsevier Ltd

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Título:
On the remarkable persistence of asymmetry in doctor/patient interaction: A critical review
Autor: Pilnick, Alison ; Dingwall, Robert
Assuntos: Asymmetry ; Biological and medical sciences ; Client Relations ; Clinical outcomes ; Communication ; Conversation analysis ; Doctor ; Doctor-patient relationship ; Doctor/patient interaction ; Doctors ; Education, Medical ; Health care ; Health Problems ; Humans ; Interpersonal communication ; Medical education ; Medical Schools ; Medical sciences ; Medical sociology ; Medicine ; Miscellaneous ; Oppression ; patient interaction Conversation analysis Asymmetry Medical education Professional dominance Review ; Patients ; Physician patient relationships ; Physician-Patient Relations ; Power (Psychology) ; Professional dominance ; Professional Training ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Reform ; Review ; Training
É parte de: Social science & medicine (1982), 2011-04, Vol.72 (8), p.1374-1382
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Descrição: Doctor/patient interaction has been the object of various reform efforts in Western countries since the 1960s. It has consistently been depicted as enacting relationships of dominance or oppression. Most younger medical practitioners have received interaction skills training during their professional education, intended to encourage more equal forms of consultation behaviour. However, the evidence that ‘patient-centredness’ has a positive impact on health outcomes is at best mixed. At the same time, empirical studies of consultations point to the remarkable persistence of asymmetry. These two factors together suggest that asymmetry may have roots that are inaccessible to training programmes in talking practices. Illustrating our argument with findings from conversation analytic studies of doctor/patient interaction, we suggest that asymmetry lies at the heart of the medical enterprise: it is founded in what doctors are there for. As such, we argue that both critical and consumerist analysts and reformers have crucially misunderstood the role and nature of medicine. ► The medical profession has long been criticised for exerting professional dominance over patients. ► A variety of reforms have attempted to address this, notably the emphasis on patient-centred medicine. ► Analysis of empirical studies of consultations shows continued asymmetry. ► We argue that this is because this asymmetry has roots that are inaccessible to talk reform. ► We advocate for a different reform project.
Editor: Kidlington: Elsevier Ltd
Idioma: Inglês

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On the remarkable persistence of asymmetry in doctor/patient interaction: A critical review

Pilnick, Alison ; Dingwall, Robert

Kidlington: Elsevier Ltd

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