Physician-Patient Relationship: Ethnography of Multiple Patient Visits at Private Offices of Doctors

Introduction: The ways in which doctors and patients interact, have an incredible impact on the quality of treatment and improvement of the disease. Although most researches agree on the impact of these relationships on the quality of healthcare, not many researches and practical work have been done on this very important field. Moreover, recently the multiple patient visit phenomenon (seeing several patients simultaneously) at the doctor's offices, especially obstetricians, is becoming common, which is clearly far from the ideal doctors-patient relationship patterns. Method: In the current research the ethnographic qualitative approach has been used. For collecting data qualitative method of participatory observation and for data analysis the procedure of theoretical coding have been used. The target community is the women going to obstetricians' offices in Ahvaz, from which ۲۸ cases of interactions between these patients and doctors have been chosen and observed through judgment sampling. Results: In the coding step the patients' verbal behavior in terms of ۳ minor categories of asking questions, expressing concerns, comments and suggestions are subcategories for the major category of "patient participatory behavior". Furthermore, the doctor's verbal behavior is the main subcategory, and encouraging the patients to talk more, and respecting the patients' ideas and beliefs are the secondary subcategories of "doctor participatory behavior". Patients' and doctors' non-verbal behavior in the process of interactions has been recorded and put in the final analysis through filling out the observation protocol, and field notes. Conclusion: According to the analysis of the obtained data, only a few doctor-patient interactions at the studied doctors' offices were real evidence of participatory behavior. This behavior was observed far less in offices with multiple patient visits than in other offices. Understanding biological, social, and cultural aspects of the disease can affect the doctor’s communication with the patient. It can even help the doctor in understanding the patients’ issues and mental or physical problems, reaching an accurate diagnosis of the disease, and choosing appropriate and efficient treatment.

کلیدواژه ها:

Doctor\'s office ، Physician-patient relationship ، Doctor\'s office ، patients ، Multiple patient visits ، Participatory ، Ethnography