Doctoral Dissertations

Date of Award

8-1986

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Sociology

Major Professor

Thomas C. Hood

Committee Members

Sam Wallace, Suzanne Kurth, Bethany Dumas

Abstract

A growing body of sociological literature has examined the ways in which predominantly male doctors communicate with female patients over the course of medical interviews. Research indicates that doc tors use the institutional authority of the medical role to control the flow of interaction, the medical interview itself and the delivery of health care to women. Less clear is our understanding of the patterns of communication between doctors and male patients.

Utilizing data gathered in a model family practice clinic of a teaching hospital in the southeastern United States, this study analyzes descriptively the ways in which doctors and male patients interact to produce medical interviews and treatment decisions. Doctor-patient communication is analyzed using discourse analysis to provide a description of: (1) the accounting practices of both doctors and male patients—what kinds of accounts the participants offer each other, how these accounts are offered and responded to and how doctors' and patients' accounting practices affect the structure of medical interviews; and (2) the negotiation of cultural assumptions or norms about how men in our society should behave—how we may locate cultural assumptions in doctor-patient discourse, how cultural assumptions are negotiated between doctors and patients over the course of medical interviews and how these cultural assumptions may affect the delivery of health care to men.

Findings suggest that while doctors employ many of the same manifestations of institutional authority with male patients as with female patients, they do so with less frequency. Doctors reject and fail to respond to male patients' accounts, but since the status of male patients is higher than that of female patients, doctors are more likely to reject and fail to respond to female patients' accounts. A similar pattern is seen in the negotiation of cultural assumptions. Doctors employ assumptions about the behaviors of their male patients and these assumptions have direct consequences for the delivery of health care. Largely because of the status difference between male and female patients, we find that doctors are most likely to negatively categorize female patients.

Download
Files over 3MB may be slow to open. For best results, right-click and select "save as..."

Share

COinS