Analysing the DoctorPatient Relationship
A Dramaturgical
Perspective.
Doctors and Patients
The discussion quickly revealed......that by far the most
frequently used drug in general practice was the doctor
himself, i.e., that it was not only the bottle of medicine or the
box of pills that mattered, but the way the doctor gave them
to his patient - in fact the whole atmosphere in which the
drug was given and taken.
(Balint M. The Doctor, His Patient and the Illness, 1986)
Dr Christopher Pearce,
University of Melbourne
Is this Relationship
Changing?
Power/Authority
Information
Technology
Changing burden of disease
Dramaturgy
Models of Interaction
Informative
Pt Autonomy
choice and
control
Dr Role
technical
expert
Interpretive
Deliberative
selfmoral self dev’t
understanding
counsellor
friend or
teacher
Based on the work of Erving
Goffman
Paternalistic
assenting
Sees social interaction as a
“performance”.
The “Self” is a socially derived
construct.
guardian
Goffman, E 1971, The Presentation of Self in Everyday Life, Pelican book ; Penguin, Harmondsworth
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FRAME (Analysis)
A Frame is:
a description of a socially derived reality
discussed in terms of :
the physical world
the social ecology
the institutional setting
Dr: “Have you got any major problems we should be aware of?”
Goffman, E 1974, Frame analysis : an Essay on the Organization of Experience, Harvard University Press, Cambridge, Mass.
Other Concepts
Key
overarching theme
Out-of-frame activity
“the telephone call”
Move
sequence of interaction
Pt: “ But Doctor, don’t you think I’m taking too many pills?”
Acknowledgments
All the worlds a stage,
And all the men and women merely players.
They have their exits and their entrances,
And one man in his time plays many parts,
His acts being seven ages.'
As You Like it, Act 1 scene 7
PhD Scholarship funded by NHMRC
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