Reviewing doctor- patient relationship: Where sociology meets medicine.

Abstract

The doctor-patient relationship forms the crux of the medical encounter and is linked to many positive patient-related outcomes. It has inspired much research interest- particularly in the western world- so much so that it has become a major research area under medical sociology. This paper attempts to review the literature on doctor-patient relationship by examining it under three broad, inter-related themes: a) power, b) communication and c) social and cultural dimensions. In terms of power dynamics, literature often indicates the doctor-patient relationship as asymmetrical. Traditionally, the doctor is depicted as authoritative, and the patient submissive and passive. However, the current ideal is a patient-centred model, where the patient’s voice is given due recognition. This attempt at redistributing power has led to a proliferation of research on patient expectations, empowerment and participation. Studies on a communicative theme focus on this relationship as a process towards achieving medical communication, which many have depicted as defective. Social and cultural dimensions may also affect the relationship, as the social gradient between the doctor and the patient may impede effective communication. A majority of the global literature on doctor-patient relationship being based on a few countries, the overall picture that emerges from a literature review such as this would approximate the conditions in developed western countries, and hence not a fair representation of the scenario in, for instance, a developing country in Asia. Further research in such contexts is therefore required for a more accurate understanding of the phenomenon and its implications.