Doctor & Patient

Parson established four norms that governed the sick role. One, the individual is not responsible for their illness. Two, exemptions of the sick from normal obligations like paid work, family duties and housework, until they are well. Three, any illness is undesirable and patients are under a social obligation to get well soon. Lastly, the ill should seek professional help from a competent physician. To control this social deviance, it’s the doctor’s role to explain these norms to the patient and make them fully understand.

Hughes (1994) explains that “Because physicians have mastered a body of technical knowledge, it is functional for the social order to allow physicians professional autonomy and authority, controlled by their socialization and role expectations”. This theory emphasizes that the doctor should be detached not impose their values on the patient. They should also act in a professional manner, obey all the codes of practice and act in the best interest of the patient and not their own.

The doctor should however be allowed to closely and intimately examine the patient and prescribe the treatment they see fit based on their experience and vast knowledge in the field. Critics have however expressed concerns about the theory as it leaves room for discrimination by the doctor to patients who have terminal diseases, the ones that the doctors dislikes and those he views as complainers. These doctors are human and are subject to personal and financial interests.

The critics also critiqued on its focus on acute illness leaving out chronic illnesses and disability. Inter cultural and inter variations also affect the interpretation of sick roles and the norms. Hughes (1994) stated that, There is also cross-class variation. Some of the poor adapt to their lack of access to medical care by becoming fatalistic, rejecting the necessity of medical treatment, and coming to see illness and death as inevitable.

On the other hand, the educated classes have become more assertive in the relationship, rejecting the norm of passivity in favor of self-diagnosis or negotiated diagnosis. The conflict theory is based on the fact that the doctor and the patient are two identities not living and acting on the same social system have different positions and roles but belong to different social systems (Oreskociv, n. d). According to the Freidson’s model, the doctor patient relationship has two different systems, the professional and the lay man side.

Each side tries to fulfill its own demand and this is how conflict arises. The conflict is between the doctor’s expectation of the patients’ behavior and the doctors believe that the patient should respect and use their judgments when seeking medical advice. However, the patients refuse to take the doctor’s advice and defer the judgment risking the rise of chronic conditions. The patients were observed using “convincing tactics” of demands, disclosure that the treatment has not worked suggestions, and leading questions.

If these did not achieve the desired change in treatment, they turned to “countering tactics” of arguing that the treatment is too weak, too powerful or insufficient. To augment their authority, the doctors used tactics of wielding overwhelming knowledge, medical threats about the consequences of ignoring advice, disclosures that the treatment may take longer to work for the patient; or a personal appeal to the patient as an acquaintance.

The outcome measures of this game theoretic situation were continuation of the relationship, patient termination of relationship, physician termination, and mutual termination (Hughes, 1994). The symbolist interactions was inspired by two trends . First, the need of physicians to improve their ability to obtain patient histories and advice best of the condition and treatment thus the ability to achieve compliance by the patient. Second, the increasing conflicts between doctors and patients, as the educated population began to challenge medical authority.

Research shows that patients appreciate a relationship in which they can ask questions, listen, answer questions, listen to the doctor’s explanation and be allowed to make decisions concerning their health. Doctors appreciate a situation where they can be allowed to examine patients, diagnose the illness and prescribe the treatment without much objection and with full compliance from the patient. These way patients become more compliant and the outcomes are better.

References

Hughes, J. (1994).Approaches to the Doctor-Patient Relationship Chapter One: The Doctor-Patient Relationship: A Review. Retrieved April 26, 2010, from http://www. changesurfer. com/Hlth/DPReview. html Oreskovic, S. Medical Sociology: Patients and physicians-role and relations. Retrieved April 26, 2010 from http://www. snz. hr/people/prezentacije/eng/Med-1_socLijecnik_pacijent_engleski. pdf Maguire, K. Doctor/Patient Relation. Sociologies of Health & Illness E-Learning Databank Retrieved April 26, 2010 from http://www. ucel. ac. uk/shield/docs/notes_doctor_patient. pdf

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