Unit.5.2.Health Profession
Unit.5.2.Health Profession
Unit.5.2.Health Profession
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Unit: V.2. Health Profession Sociology for Health Sciences
Respect for others (patients and their families, other physicians and professional
colleagues such as nurses, medical students, residents, subspecialty fellows, and self)
is the essence of humanism"
Socialization
Socialization is the lifelong process of interaction through which individuals acquire a
self-identity and the physical, mental, and social skills needed for survival in society.
W.H. Ogburn says “Socialization is a process by which the individual learns to
conform to the norms of the group”.
Bogardus define “Socialization as the process of working together, of developing
group responsibility, of being guided by welfare needs of others”.
The Socialization of the Physician
Process to become a doctor is long, difficult and costly
Medical students go through a socialization process
Need to learn how to tolerate uncertainty
Increasing diversity in medical school
Changes in conceptualization of medicine and medical practice effect education
Professionalism
Role of the doctor within the health service
Understanding of the health care system
Understanding of clinical responsibilities
Appreciation of doctor as researcher
Appreciation of doctor as mentor or teacher
Motivation
Appreciation of doctor as manager including quality control
Team working
Personal Development
Lifelong Learner
Self confidence
Self awareness
Self regulation
o Self care
o Self control
o Personal time
o Management
Motivation
o Achievement drive
o Commitment
o Initiative
Career choice
Commitments of Professional Doctor
To professional competence
To honesty with patients
To patients’ confidentiality
To maintaining appropriate relationships
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Unit: V.2. Health Profession Sociology for Health Sciences
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Unit: V.2. Health Profession Sociology for Health Sciences
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Unit: V.2. Health Profession Sociology for Health Sciences
Poor bedside manner leaves the patient feeling unsatisfied, worried, frightened, or
alone.
Patient Behaviour
The behaviour of the patient affects the doctor–patient relationship.
Rude or aggressive behaviour from patients or their family members can also distract
healthcare professionals and cause them to be less effective or to make mistakes
during a medical procedure.
When dealing with situations in any healthcare setting, there is stress on the medical
staff to do their job effectively. Whilst many factors can affect how their job gets
done, rude patients and unappealing attitudes can play a big role.
Types of Doctor Patient Relationship
Four types of Doctor-Patient Relationship
Paternalism
Consumerism
Mutuality
Default
Controlled Based Doctor-Patient Relationship
Doctor controlled
Patient controlled
Physician control
Relationship
Low High
Low Default Paternalism
Patient Control
High Consumerism Mutuality
1. Paternalism
Traditional form of doctor-patient relationship
Doctor takes on role of parent
Doctor is the expert and patient expected to cooperate
Tightly controlled interviewing style aimed at reaching an organic diagnosis
A Passive patient and a dominant doctor
Focus is on care, rather than autonomy
Advantages of Paternalism
The supportive nature of paternalism appears to be important when patients are very
sick at their most vulnerable.
Relief from the burden of worry is curative in itself, and the trust and confident
implied by this model allows doctor to perform “medical magic”.
Disadvantage of Paternalism
Manipulation and exploitation of the vulnerable and ill.
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Unit: V.2. Health Profession Sociology for Health Sciences
2. Mutuality
The optimal doctor-patient relationship model
This model views neither the patient nor the physician as standing aside
Each of participants brings strengths and resources to the relationship
Based on the communication between doctors and patients
Patients
Patients need to define their problems in an open and full manner.
The patient has right to seek care elsewhere when demands are not satisfactorily met.
Physicians
Physicians need to work with the patient to articulate the problem and refine the
request.
The physician’s right to withdraw services formally from a patient if he or she feels it
is impossible to satisfy the patient’s demand.
Advantages of Mutuality Approach
Patients can fully understand what problem they are coping with through physicians’
help
Physicians can entirely know patient’s value
Decisions can easily be made from a mutual and collaborative relationship
Disadvantages of Mutuality Approach
Physicians do not know what certain degree should they reach in communication
Is the patient capable of making the important therapeutic decisions
3. Consumerism
We can simplify the complicated relationship with “buyer and seller” relationship.
The patient can challenge to unilateral decision making by physicians in reaching
diagnosis and working out treatment plans
Reversing the very basic nature of the power relationship
Patient:
Health shoppers so consumer behaviour
Cost-consciousness
Information seeking
Exercising independent judgment
Doctor:
Health care providers
Technical consultant
To convince the necessity of medical services
Advantages of Consumerism
Patients can have their own choices.
Disadvantages of Consumerism
When things seem to go wrong, when satisfaction is low, or when a patient suspect
less than optimal care or outcome, patients are more likely to question physician
authority.
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Unit: V.2. Health Profession Sociology for Health Sciences
4. Default
When patient and physician expectation are at odds, or when the need for change in
the relationship cannot be negotiated, the relationship may come to a dysfunction
standstill.
Patient Controlled Consultation
“You’re paid to do what I tell you!!”
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Unit: V.2. Health Profession Sociology for Health Sciences
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Unit: V.2. Health Profession Sociology for Health Sciences
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