Patients' influence on doctors' behavior: a case study of patient strategies in somatization.
OBJECTIVE
Extensive empirical data and theory describe the inequality of power in relations between doctors and their patients. However, the focus has been on the ways in which doctors control the doctor-patient relationship. This has meant that the extent to which patients influence the consultation, and the ways in which they do this, have been neglected.


METHODS
In this article, we use a single case to identify and illustrate distinct ways in which patients exert power to determine the outcome of consultations.


CONCLUSIONS
This analysis leads to a more powerful explanation than is presently available to understand the somatization of psychological needs. According to this, the patient organizes strategies, which include the presentation of emotional and social distress, around a biomedical model. Because of their prior decisions as to their role, doctors permit themselves to be trapped in this model.
Salmon
P
P
Department of Clinical Psychology, University of Liverpool, United Kingdom.
May
C R
CR
D003142:Communication; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D010817:Physician-Patient Relations; D011209:Power, Psychological; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology*