The Management of the Doctor-Patient Relationship

By Richard H. Blum | Go to book overview

land advises the doctor to be willing to accept the dependence of the patient on the doctor during postsurgical care; the doctor should not reject or fend off the patient during this period.


Culture Conflict in Convalescence

The average American physician will want to speed recovery to the point where the patient achieves his independence once again. That desire is born of our culture's emphasis on independence, hard work, and the virtue of earning one's own way. As Sutherland points out, this "Yankee" virtue may not fit the ideas of some convalescing patients from other cultures or subcultures [15]. The doctor may feel obliged to return the patient to gainful activity, but the patient may feel no such ambition.

The patient's cultural background may dictate that continued dependency, based on a minor physical handicap, is a perfectly fine way of life. The patient's family may agree that work is no necessary goal of a cure. Both family and patient may be quite content if the patient does not return to a job. The doctor may consider the patient a rehabilitation failure, and he may either blame himself for the "failure" or he may accuse the patient of malingering. Neither accusation is warranted. It is a case of culture conflict where doctor and patient have different ideas about how a person should live his life.

Sutherland warns against the doctor starting needless trouble in the doctor-patient relationship. The doctor should not confuse acculturation (teaching a person the values of a given culture) with rehabilitation. In the case of many patients from peasant societies (Sicilian, Neopolitan, Spanish American, Southern rural Negro) the doctor may achieve medical rehabilitation without his patients ever going back to work. The understanding and acceptance of cultural differences is a necessary ingredient for the maintenance of a steady doctor-patient relationship.


BIBLIOGRAPHY
1
The changing pattern of hospital use, Progress in Health Services, vol. 7, Health Information Foundation, New York, 1958.
2
Anderson Odin W., and Jacob J. Feldman: Family Medical Costs and Voluntary Health Insurance: A Nationwide Survey, McGraw-Hill Book Company, Inc., Blakiston Division, New York, 1956.
3
The increased use of medical care, Progress in Health Services, vol. 7, Health Information Foundation, New York, 1958.
4
Ulett Pearl C., and F. Gildea: Survey of surgical procedures in psyeboncurotic women, J.A.M.A. 143: 960, 1950.
5
MacEacbern Malcolm T.: Hospital Organization and Management, Physician's Record Co., Chicago, 1957.

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The Management of the Doctor-Patient Relationship
Table of contents

Table of contents

  • Title Page iii
  • Foreword vii
  • Preface ix
  • Contents xi
  • Introduction xiii
  • Bibliography xiv
  • 1 - The Patient's Definition of Illness 1
  • Bibliography 28
  • 2 - The Patient's Attitude and Reaction Toward Illness 29
  • Bibliography 65
  • 3 - The Patient's Attitude Toward the Doctor 67
  • Bibliography 93
  • 4 - The Unreasonable Patient 94
  • Bibliography 108
  • 5 - The Uncooperative Patient 110
  • Bibliography 118
  • 6 - Patient Ignorance and Its Cure 119
  • Bibliography 149
  • 7 The Office Call 150
  • Bibliography 169
  • 8 - Concluding the Office Call 170
  • Bibliography 189
  • 9 - After the Office Call 191
  • Bibliography 210
  • Bibliography 235
  • 11 - The Surgical Patient 237
  • Bibliography 265
  • 12 - Getting the Family Involved 267
  • Bibliography 276
  • 13 - The Doctor 277
  • Bibliography 290
  • 14 - Medical Public Relations 292
  • Bibliography 298
  • Name Index 299
  • Subject Index 301
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