Some implications for the study of the doctor-patient interaction: Power, structure, and agency in the works of Howard Waitzkin and Arthur Kleinman

Pappas, Gregory Fernando

doi:10.1016/0277-9536(90)90080-c

Cited by 42 publications

(20 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Even the most seemingly 'powerless' people are able to mobilize some types of resources to establish control over aspects of their daily lives (Pappas, 1990). CAM offered a way for our participants to claim control over lives disrupted by chronic illness and its trajectory.…”

Section: Discussionmentioning

confidence: 99%

Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management

et al. 2012

View full text Add to dashboard Cite

The chronicity of chronic disease, and its associated uncertainties and fluctuations in health status, pain and/or discomfort, often leaves those so diagnosed feeling that they have lost control. Treatment can exacerbate this sense of loss of control, as people surrender to the expertise of their biomedical providers and interventions. In principle, self-management aims to return control to the individual, but its promotion is as much motivated by cost-containment as patient autonomy, and is advocated in an environment largely shaped by policy makers and biomedical providers. In this article, we examine how Australians with type 2 diabetes and/or cardiovascular disease supplement medical with complementary and alternative medical (CAM) care. Drawing on in-depth interviews with 69 participants collected in 2009-2010, we illustrate how people rely on medical providers and pharmaceuticals to manage their diabetes, but concurrently consulted with CAM practitioners and used non-biomedical therapies to enhance well-being. In explaining this, participants framed CAM use in the context of reclaiming relative personal and bodily control.

show abstract

Section: Discussionmentioning

confidence: 99%

Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Two approaches are used: those which examine the relationship at an individualistic level and those which place the relationship within the wider power relationships of society (Pappas, 1990). Conflict issues between the health professional and the user are interpreted on the one hand as arising from a clash of explanatory models or different frames of reference and on the other as resulting from political and economic differences.…”

Section: Quality Of Health Servicesmentioning

confidence: 99%

Anthropology in research on the quality of health services

Atkinson

1993

Cad. Saúde Pública

View full text Add to dashboard Cite

“…Separation of structure and process in the study of health care practices has been criticized, as this limits the scope of analyses ( Pappas 1990). For instance, it has been suggested that professional cooperation in health care is hampered by class ( Davies 1979) and tradition ( Keddy et al .…”

Section: Discussionmentioning

confidence: 99%

The patient and the primary care team: a small‐scale critical theory

Timpka

2000

Journal of Advanced Nursing

View full text Add to dashboard Cite

The patient and the primary care team: a small-scale critical theory For increasing the understanding of team-based delivery of primary care, ratings of care satisfaction and stimulated-recall interviews were used to compose a small-scale critical theory. Three teams and 24 patients at a community health care centre participated in the study. It was found that the multiprofessional team was vulnerable to discrepancies between the health service policy and the available care resources. If pre-paid patients arrive with too high expectations and demands on the service, a significant part of the team's attention is used for economizing with care procedures. When health and economics are entangled for the team, the patients are not invited to share decisions about their health. The patients' concerns are instead turned to the social arena, which is separated by language and context from the health analysis. Simultaneously, when the teams are led to solve the health problems without involving the patients in the process, the team members convert these to their own personal distress when they fail. The conclusion is that the discrepancy between care policy and factual resources is an important cause of imbalance in patient-primary care team interaction. If service strategy and team organization and resources are not continuously adjusted to each other, the effects will continue to obstruct communication during consultations.

show abstract

Some implications for the study of the doctor-patient interaction: Power, structure, and agency in the works of Howard Waitzkin and Arthur Kleinman

Cited by 42 publications

References 8 publications

Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management

Taking control: Complementary and alternative medicine in diabetes and cardiovascular disease management

Anthropology in research on the quality of health services

The patient and the primary care team: a small‐scale critical theory

Contact Info

Product

Resources

About