Demanding patient or demanding encounter?: A case study of a cancer clinic

Abstract

This paper explores the sociological relevance of demanding encounters between doctors and patients. Borrowing from Potter and McKinlay's (2005) reconceptualization of the doctor-patient relationship, we suggest an analytic shift away from `demanding patients' toward `demanding encounters'. Such a shift places provider-patient conflict within a broader sociocultural context, emphasizing constraints facing both doctor and patient as they interact in a clinical setting. Specifically, through an ethnographic study of doctor-patient interactions at the oncology clinic of a US University Hospital, we examine the respective influences of new information technologies and patient consumerism in the production of demanding encounters in oncology. Findings suggest that these interconnected socio-cultural realities, in tandem with patient tendencies to challenge physician judgment or expertise, play a role in demanding encounters. We conclude by considering the implications of demanding encounters for doctors, patients and healthcare organizations.

Peering into the pharmaceutical “pipeline”: Investigational drugs, clinical trials, and industry priorities

“…A final stream of research focuses on specific clinical trials and examines the perspectives of enrolled research participants (e.g., Bishop et al, 2012; Lowton, 2005; Morris & Balmer, 2006). Having some conceptual overlap with literature on pharmaceuticalization, this scholarship engages how research participants make sense of elements of study design (like randomization and placebo use) in ways that often underscore their desire for medical treatment, especially when their access to health care is limited (Stacey et al, 2009; Timmermans & McKay, 2009). …”

Autonomy and the “demanding encounter” in clinical neurology

“…4 Examples outside of neurology include patients with viral upper respiratory symptoms who demand antibiotics, with chest pain from anxiety who demand a cardiac catheterization despite extensive negative noninvasive testing, or with fatigue who want a PET scan to look for cancer. These patients often see themselves as informed consumers who expect to receive requested interventions from their health care providers.…”

Please leave your phone outside: policymakers and medical app providers are encouraging patient participation, but doctors in the consult room are not

“…Researchers have found that some doctors enjoy the challenge of an IIP and are positive about the potential for greater patient education and involvement generated by the internet 6. Unfortunately, reports of negative reactions to IIP currently dominate, with the literature reporting doctors' reactions as frustration, irritation and even outright disgust.…”

“…Researchers took a comprehensive observational approach in just two studies, interviewing patients preappointment and postappointment and also audio recording or observing the consultation 6 41. Most research was attitudinal and two prominent themes emerged from the attitudinal literature: the negative reactions reported by patients and doctors' justifications for such reactions.…”