Chapter 16: Clinical Narratives and the Study of Contemporary Doctor-Patient Relationships
Mary-Jo Delvecchio Good & Byron J. Good
Clinical narratives and the study of contemporary doctor-patient relationships In a series of essays published in JAMA , David Mechanic, one of the major medical sociologists of our era, addressed the contemporary eroding of traditions of ‘trust’ that has characterized ideal relationships between American physicians and their patients over much of the second half of the twentieth century (Mechanic 1997; Mechanic and Schlesinger 1996). The recent reorganization of American health services as capitated managed care systems, the shift in the balance of physicians' fiduciary responsibilities from individual patients to larger patient populations or stockholders in managed care groups, and shifts in professional relationships resulting from newly emerging biotechnologies have fostered public controversy and professional unrest (Gray 1997). From an international perspective, these changes in American medicine seem to reflect broader global changes in biomedical therapeutics, the medical profession, and relationships among doctors, patients, and the public. In this chapter, we ...