Doctor–Patient Relationships

Abstract

Doctor–patient relationships often suffer from barriers that impede communication and understanding. These barriers include socioeconomic conditions such as inequality; structural racism and marginalization of minority populations; and traumatic experiences associated with war and migration. Explanatory models of disease also pose a significant barrier because of differing cultural understandings of sickness and physical symptoms that practitioners may not recognize but also because of social class differences, insufficient educational opportunities, discrimination, and other structural conditions. Refugee and indigenous patients whose cultures have not traditionally utilized mainstream Western medicine illustrate such challenges in doctor–patient relationships. Problems of the social context such as poverty, inequality, and marginalization impinge on medical encounters, partly by creating mental distress and suffering, and warrant changes in social policies that extend beyond the doctor–patient relationship itself.