Doctor-Patient Relationships in the Context of Asynchronous Online Consultations on Oncology: the Boundaries of Autonomy and Consumerism

Modern sociological research related to oncology issues is predominantly focused either on the lives of those who have survived cancer (studies of the social status and self-perception of cancer patients, lifestyle after cancer, feminist studies dedicated to women with breast cancer), or on the social determinants of cancer. However, studies devoted to oncological discourses, as well as directly to the process and nature of interaction between doctor and patient during treatment and, in particular, diagnosis of diseases, are very few. This paper attempts to contribute to solving this problem. The conducted research is generally aimed at studying the relationship between doctors and patients during the diagnosis of malignant neoplasms through the prism of theoretical approaches of the sociology of professions and the sociology of medicine (and primarily on the basis of the sociology of oncology taking shape in Western sociology). As part of this work, we studied the boundaries of autonomy, the redistribution of power and responsibility of doctors and patients, and the trends of consumerism in the process of asynchronous online consultations on oncology issues. To analyze the collected data, digital analytics methods were used, namely topic modeling and sentiment analysis, and qualitative content analysis. Based on the results of the study, we can conclude that, firstly, asynchronous online consultations are a way to overcome the competence gap and information asymmetry between the doctor and the patient, and secondly, they act as an emotional regulator when the patient experiences fear and anxiety. In the interaction of a doctor with a patient within the framework of asynchronous online consultations, both a paternalistic model and a liberal or participatory one can be traced. The paternalistic model of interaction includes the answers of doctors, the content of which includes a dry interpretation of research, often without an attempt to explain the results in a language accessible to the patient, a listing of facts and a set of actions (often in the imperative mood) that the patient needs to perform. In the participatory model, the patient is a full participant in the treatment process, has informed consent and the will to choose treatment from a number of alternatives. In fact, we are talking about empowering the patient and taking an actor position. The liberal or participatory model, which assumes greater autonomy of the patient and his right to information, includes answers in which doctors try to communicate with the patient in the same language, give clear examples, and give recommendations in the form of advice. Also, in this model of interaction, doctors carry out emotional work.