Demanding patient or demanding encounter?: A case study of a cancer clinic

Soc Sci Med. 2009 Sep;69(5):729-37. doi: 10.1016/j.socscimed.2009.06.032. Epub 2009 Jul 18.

Abstract

This paper explores the sociological relevance of demanding encounters between doctors and patients. Borrowing from Potter and McKinlay's [(2005). From a relationship to encounter: an examination of longitudinal and lateral dimensions in the doctor-patient relationship. Social Science & Medicine, 61, 465-479] reconceptualization of the doctor-patient relationship, we suggest an analytic shift away from 'demanding patients' toward 'demanding encounters'. Such a shift places provider-patient conflict within a broader socio-cultural context, emphasizing constraints facing both doctor and patient as they interact in a clinical setting. Specifically, through an ethnographic study of doctor-patient interactions at the oncology clinic of a US University Hospital, we examine the respective influences of new information technologies and patient consumerism in the production of demanding encounters in oncology. Findings suggest that these interconnected socio-cultural realities, in tandem with patient tendencies to challenge physician judgment or expertise, play a role in demanding encounters. We conclude by considering the implications of demanding encounters for doctors, patients and healthcare organizations.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel
  • Consumer Health Information*
  • Dissent and Disputes*
  • Female
  • Hospitals, University
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Oncology Service, Hospital
  • Patient Acceptance of Health Care
  • Patient Education as Topic
  • Patient Participation*
  • Patients / psychology*
  • Physician-Patient Relations*
  • Socioeconomic Factors
  • Sociology, Medical
  • United States