Examining the doctor-patient relationship : knowledge, vulnerability, and power in women's health care narratives

Kosny, Agnieszka Arlette (1999) Examining the doctor-patient relationship : knowledge, vulnerability, and power in women's health care narratives. Masters thesis, Memorial University of Newfoundland.

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Abstract

This study examined women's perceptions of their interactions with doctors. I interviewed twenty women with different levels of formal education. One group had no more than a high school diploma and another group had completed at least four years of university. -- In my research, I used in-depth, semi-structured interviews to collect data. I asked women about their health and about the specific aspects of the doctor-patient interaction they found positive and negative. I involved women in an exploration of their own experiences by asking them to theorize about why they were treated in certain ways by doctors and the health care system. The interviews were analyzed using meaning condensation and theme analysis. -- Most of the women I spoke with saw their health and health care in a holistic manner. Their narratives encompassed three different levels of experience; the relational, the personal, and the social. Women wanted doctors to recognize that a variety of economic, social, and societal factors influence their well-being. The themes of communication, information, power, quality and quantity of time spent, value given to the patient, and the doctor's personal manner had the greatest influence on the quality of the doctor-patient relationship. Many women told me about experiences connected to gynecological and reproductive health. These experiences (both good and bad) seemed to have a profound impact on patients. -- There were several differences between the two groups of women I interviewed. High school educated women were more often concerned that a doctor was not being honest with them and they seemed to be less confident about asking questions and demanding information when they were having a negative interaction with a doctor. Women in the university educated group were more likely to expect that a doctor personalize a treatment or service to fit their individual needs. University educated women also wanted physicians to trust their judgement, while high school educated women did not tell me about similar expectations. -- Several of the participants in my study told me about incidences of sexual misconduct by their doctor. It is noteworthy that there was a general lack of awareness about the procedures of reporting a doctor's inappropriate behaviour and most participants were reluctant about filing official complaints about improper behavior (both sexual and non-sexual). Although many women reported incidences with doctors that were negative, most women did not simply accept negative treatment. There was ample evidence of resistance and subversion in my study. -- I hope that my study gives voice to women's experiences and theories about their interactions with doctors and about the health care system. The information gathered in my study can be used as a resource for medical schools, health care providers, policy makers, and other researchers. A diversity of women's input is essential if medical education and health care policies can reflect a variety of women's experiences and needs.

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