Women marginalized by poverty and violence. How patient-physician relationships can help

To explore the experiences of women relegated to the margins of society by poverty or violence.

Qualitative method of focus groups.

Shelters and transitional housing in southwestern Ontario.

Thirty-six women staying at shelters or transitional housing.

Focus groups conducted at five locations explored the women's experiences and interactions with family physicians.

Two themes emerged from the analysis: power imbalances in patient-physician relationships, and the role of family physicians in creating collaborative relationships. Women who felt demeaned in patient-physician relationships described their family physicians as dominating and intimidating. Women who described relationships as collaborative felt valued and understood.

Poor or abused women living in shelters who felt powerless in patient-physician relationships felt even more demeaned as they coped with the struggles associated with being poor. Women who had continuous collaborative relationships with their family physicians were able to articulate their needs more readily.