chapter  6
21 Pages

The medical consultation

Contemporary research has confirmed the pers1stmg empirical rarity o f the patient participation model of the consultation. Indeed, this has been a recurrent theme from the early studies of the patient perspective in the 1 970s and 1 980s through to the present day. Stimson and Webb ( 1 97 5 ) first introduced the patient' s perspective of the medical encounter. Their study revealed the contrast between the passive and deferential demeanour of patients during the consulta­ tion, and the critical appraisal they brought to bear on this afterwards (Box 6 . 1 ) . Byrne and Long ( 1 97 6 ) found that the overwhelming maj ority of the 2 500 consultations they analysed were dominated by the doctor. Attempts to elicit patient ideas or concerns, or to invite patients' active participation in the interview were rare . Their argument that medical care and health outcomes would be improved by encouraging patients to play an active role in managing their healthcare was taken forward in the 1 980s by Tuckett et al. ( 1 98 5 ) .