ABSTRACT
This chapter reviews models of interaction, misunderstandings in communication, and cultural differences in presenting symptoms, and problems in patient compliance. It examines the various social factors that affect doctor–patient interaction. The chapter describes gender bias in medicine and discusses the effects of new technology on doctor–patient relationships. It also explains how genomic information affects the management of illness. Depending on the severity of symptoms, Szasz and Hollender argue that physician–patient interaction falls into one of three possible models: activity-passivity, guidance-cooperation, and mutual participation. The activity-passivity model applies when the patient is seriously ill or being treated on an emergency basis in a state of relative helplessness, because of severe injury or lack of consciousness. The guidance-cooperation model arises most often when the patient has an acute, often infectious illness, such as flu or measles. The mutual participation model applies to the management of chronic illness in which patient works with doctor as full participant in controlling the affliction.
