[Stated theory of family doctors on their relationships with patients].
OBJECTIVE
To identify and analyse the "theory" expressed by family doctors on the essential features of an effective and functional doctor-patient relationship and on how to achieve one ("stated theory" of Argyris and Schon).


METHODS
Qualitative, based on discourse analysis.


METHODS
Primary care.


METHODS
Interviews recorded with 10 family doctors selected by intentional sampling that were then transcribed. The propositions in the discourses were identified and conceptual maps were constructed. An inductive analysis classified the questions and positions that emerged and identified similarities and differences between subjects.


RESULTS
Confidence and absence of conflict were the main desirable features of the doctor-patient relationship. Patients with a "demanding" attitude and their dishonesty were the most quoted obstacles. Doctors accepted negotiation, but held a very limited view of patient participation. Differences were appreciated on distance, the biomedical versus psychosocial focus and health education. Doctors' communication skills and qualities were little cited. Technical terminology in this area appeared little in the discourses.


CONCLUSIONS
Discourses highlighted "health consumerism" and revealed disagreements on distance in the relationship and the psycho-social approach. These points, which should be prioritised in training, along with education, can serve to define family doctors distinct professional orientations. Training methodology must bear in mind that experience dominates "stated theory" in this area.
Loayssa Lara
José Ramón
JR
Medicina de Familia, Centro de Salud de Noáin, Servicio Navarro de Salud, Noáin, Navarra, Spain. jloayssal@papps.org
González García
Fermín
F
Ruiz Moral
Roger
R
D003071:Cognition; D003142:Communication; D005194:Family Practice; D006801:Humans; D007407:Interviews as Topic; D010358:Patient Participation; D010819:Physician's Role; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011584:Psychology; D036301:Qualitative Research