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On the creation of 'problem' patients.

A L Wright¹, W J Morgan

¹Department of Pediatrics, University Medical Center, Tucson, AZ 85724.

Social Science & Medicine (1982)

|January 1, 1990

Summary

This study examines clinical interactions by combining macro-level forces and patient perceptions. Understanding both perspectives is key to navigating challenging patient encounters and improving healthcare outcomes.

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Area of Science:

Sociology of Health and Illness
Medical Sociology
Clinical Communication

Background:

Debates in clinical transactions highlight a divide between macro-level (political, economic, institutional) and micro-level (patient perceptions) influences.
Understanding patient-provider interactions is crucial for effective healthcare delivery.
The concept of 'problem patients' often arises from a disconnect between medical and patient viewpoints.

Observation:

This paper integrates macro-level analysis with patient belief approaches to study interactions with 'problem patients'.
Macro-level factors reveal power dynamics and the process of medicalization, where medical values are prioritized.
The patient belief approach focuses on the 'disease model of illness' as a tool in the struggle for control within clinical encounters.

Findings:

Combining macro-level and patient belief perspectives offers a more comprehensive understanding of clinical medicine.
Power negotiation and medicalization significantly shape interactions with patients who deviate from medical norms.
The disease model of illness is a critical element in the dynamic of control during clinical encounters.

Implications:

This dual approach enhances our comprehension of complex clinical interactions, particularly those involving 'problem patients'.
Recognizing both systemic influences and patient perspectives can lead to more effective and patient-centered care.
The findings suggest a need for healthcare systems to address power imbalances and integrate patient beliefs into treatment paradigms.

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