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Communication and Medicine

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When talking to the patient is difficult: The physician's perspective

Elena Vegni / Sonia Visioli / Egidio A. Moja
Published Online: 2005-07-27 | DOI: https://doi.org/10.1515/come.2005.2.1.69


The aim of the study was to analyze the difficult doctor–patient relationship from a doctor's perspective. A qualitative–interpretative approach was employed to analyze representations of difficult visits collected by means of written narrations. Two main scenarios were identified: (i) a ‘personal scenario’ in which the doctor had difficulties from a purely personal perspective; and (ii) a ‘professional scenario’ in which the doctor had difficulties as a professional when the ‘other’ resists or in facing the ‘other’ who resists. A further scenario was identified in which problems were generated by the family of the patient. Results suggest that the relation between doctor and patient may be very complex. Difficulties may be internal to the doctor, hence intra-psychic, depending on being both a professional and a human being. Difficulties may also be external between two psychological subjects (labeled as inter-psychic), where interaction of the ‘you’ and the ‘other’ becomes a battleground, a wall of opposition, or alternatively a place of experimentation with relationships. Furthermore, external difficulties may also be between more than two persons (labeled as inter-personal), by the possible multiplicity of the ‘other’. This happens in particular when the ‘other’ is represented by the family.

Keywords: narratives; physician–patient relations; grounded theory; patient-centered medicine

About the article

Elena Vegni, M.A. (4-year degree in philosophy) is apsychologist. She is a research fellow at the Chair of Medical Psychology at the School of Medicine, University of Milan. She is a tutor of reference for the course on Health Communication, and senior tutor in CME workshops regardinghealth communication skills. Her research interests are in the field of health professional–patient relations, with both qualitative and quantitative approaches. Address for correspondence: Department of Medicine, Surgery and Dentistry, San Paolo Hospital, Via di Rudinì 8, Milan, I-20142 Italy.

Published Online: 2005-07-27

Published in Print: 2005-01-01

Citation Information: Communication & Medicine, Volume 2, Issue 1, Pages 69–76, ISSN (Online) 1613-3625, ISSN (Print) 1612-1783, DOI: https://doi.org/10.1515/come.2005.2.1.69.

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