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

摘要

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.