Doctor-patient relationship in the context of asynchronous online consultations on oncology: the boundaries of autonomy and consumerism
On June 17, 2024 a seminar was held on the topic "Doctor-patient relationship in the context of asynchronous online consultations on oncology: the boundaries of autonomy and consumerism", organized within the framework of the Research Group "Doctor-nurse-patient relationship: between professional authority and the powers of consumers of medical services".
At the seminar Alexandra Kamenskaya, a member of the Research Group "Doctor-nurse-patient relationship: between professional authority and the powers of consumers of medical services", research assistant at the ILSIR, presented as part of her speech at the seminar, the results of a content analysis of consultation branches on oncology which have been published on the website of the "Ask the Doctor". Based on the theoretical framework and a review of sources, Alexandra identified five thematic blocks: the motives of patients' treatment, the doctor's communicative model in response, the emotions of patients and doctors, the doctor-doctor relationship, and manageralism.
As a result of the content analysis, it was revealed that 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 usually refers to the autonomy of the doctor in a clinical situation, his leadership of the treatment process, while the patient must follow the prescriptions. This type of interaction can include answers, the content of which includes a dry interpretation of the research, often without trying to explain the results in a language accessible to the patient, listing facts and a set of actions (often in the imperative mood) that the patient needs to perform.
The answers of doctors problematize managerialism in the field of healthcare, mediating the doctor-patient relationship and expressed in the standards of diagnosis and medical care. In narratives, doctors are more supportive of standards, which can be explained both by professional socialization and benefits that reduce the risk of lawsuits.
The debater was Yana Gorbatenko, a PhD student at the Department of History of the HSE Campus in St. Petersburg, a member of the Research Group "Social and Cultural Studies of Medicine of the XVIII – XXI centuries" noted in her comment the special relevance of the content analysis method for describing emotional components in doctor and patient communication.
We sincerely thank Yana Gorbatenko and all the participants of the discussion for their attention to the research and for valuable comments!
The recording of the seminar is available at the link.
