From patient deference towards negotiated and precarious informality : An Eliasian analysis of English general practitioners' understandings of changing patient relations. / Brown, Patrick; Elston, Mary; Gabe, Jonathan.

In: Social Science & Medicine, Vol. 146, 12.2015, p. 164-172.

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@article{3f3783a8edf940e0b6273ed2f63ec369,
title = "From patient deference towards negotiated and precarious informality: An Eliasian analysis of English general practitioners' understandings of changing patient relations",
abstract = "This article contributes to sociological debates about trends in the power and status of medical professionals, focusing on claims that deferent patient relations are giving way to a more challenging consumerism. Analysing data from a mixed methods study involving general practitioners in England, we found some support for the idea that an apparent `golden age’ of patient deference is receding. Although not necessarily expressing nostalgia for such doctor-patient relationships, most GPs described experiencing disruptive or verbally abusive interactions at least occasionally and suggested that these were becoming more common. Younger doctors tended to rate patients as less respectful than their older colleagues but were also more likely to be egalitarian in attitude. Our data suggest that GPs, especially younger ones, tend towards a more informal yet limited engagement with their patients and with the communities in which they work. These new relations might be a basis for mutual respect between professionals and patients in the consulting room, but may also generate uncertainty and misunderstanding. Such shifts are understood through an Eliasian framework as the functional-democratisation of patient-doctor relations via civilising processes, but with this shift existing alongside decivilising tendencies involving growing social distance within broader social figurations.",
keywords = "consumerism, deference, doctor-patient relationship, Elias, medical profession, violence, United Kingdom",
author = "Patrick Brown and Mary Elston and Jonathan Gabe",
year = "2015",
month = "12",
doi = "10.1016/j.socscimed.2015.10.047",
language = "English",
volume = "146",
pages = "164--172",
journal = "Social Science & Medicine",
issn = "0277-9536",
publisher = "Elsevier Limited",

}

RIS

TY - JOUR

T1 - From patient deference towards negotiated and precarious informality

T2 - An Eliasian analysis of English general practitioners' understandings of changing patient relations

AU - Brown, Patrick

AU - Elston, Mary

AU - Gabe, Jonathan

PY - 2015/12

Y1 - 2015/12

N2 - This article contributes to sociological debates about trends in the power and status of medical professionals, focusing on claims that deferent patient relations are giving way to a more challenging consumerism. Analysing data from a mixed methods study involving general practitioners in England, we found some support for the idea that an apparent `golden age’ of patient deference is receding. Although not necessarily expressing nostalgia for such doctor-patient relationships, most GPs described experiencing disruptive or verbally abusive interactions at least occasionally and suggested that these were becoming more common. Younger doctors tended to rate patients as less respectful than their older colleagues but were also more likely to be egalitarian in attitude. Our data suggest that GPs, especially younger ones, tend towards a more informal yet limited engagement with their patients and with the communities in which they work. These new relations might be a basis for mutual respect between professionals and patients in the consulting room, but may also generate uncertainty and misunderstanding. Such shifts are understood through an Eliasian framework as the functional-democratisation of patient-doctor relations via civilising processes, but with this shift existing alongside decivilising tendencies involving growing social distance within broader social figurations.

AB - This article contributes to sociological debates about trends in the power and status of medical professionals, focusing on claims that deferent patient relations are giving way to a more challenging consumerism. Analysing data from a mixed methods study involving general practitioners in England, we found some support for the idea that an apparent `golden age’ of patient deference is receding. Although not necessarily expressing nostalgia for such doctor-patient relationships, most GPs described experiencing disruptive or verbally abusive interactions at least occasionally and suggested that these were becoming more common. Younger doctors tended to rate patients as less respectful than their older colleagues but were also more likely to be egalitarian in attitude. Our data suggest that GPs, especially younger ones, tend towards a more informal yet limited engagement with their patients and with the communities in which they work. These new relations might be a basis for mutual respect between professionals and patients in the consulting room, but may also generate uncertainty and misunderstanding. Such shifts are understood through an Eliasian framework as the functional-democratisation of patient-doctor relations via civilising processes, but with this shift existing alongside decivilising tendencies involving growing social distance within broader social figurations.

KW - consumerism, deference, doctor-patient relationship, Elias, medical profession, violence, United Kingdom

U2 - 10.1016/j.socscimed.2015.10.047

DO - 10.1016/j.socscimed.2015.10.047

M3 - Article

VL - 146

SP - 164

EP - 172

JO - Social Science & Medicine

JF - Social Science & Medicine

SN - 0277-9536

ER -