title: Medical paraclinical standards, political economy of clinic, and patients' clinical dependency; a critical conversation analysis of clinical counseling in South of iran.
abstract: BACKGROUND
  Despite its benefits and importance, clinical counseling affects the patient both psychosocially and socially. Illness labeling not only leads to many problems for patient and his/her family but also it imposes high costs to health care system. Among various factors, doctor-patient relationship has an important role in the clinical counseling and its medical approach. The goal of this study is to evaluate the nature of clinical counseling based on critical approach.
  
  
  METHODS
  The context of research is the second major medical training center in Shiraz, Iran. In this study, Critical Conversation Analysis was used based on the methodologies of critical theories. Among about 50 consultation meetings digitally recorded, 33 were selected for this study.
  
  
  RESULTS
  RESULTS show that the nature of doctor-patient relationship in these cases is based on paternalistic model. On the other hand, in all consultations, the important values that were legitimated with physicians were medical paraclinical standards. Paternalism in one hand and standardization on the other leads to dependency of patients to the clinic.
  
  
  CONCLUSIONS
  Although we can't condone the paraclinical standards, clinical counseling and doctor-patient relationship need to reduce its dominance over counseling based on interpretation of human relations, paying attention to social and economical differences of peoples and biosocial and biocultural differences, and focusing on clinical examinations. Also, we need to accept that medicine is an art of interaction that can't reduce it to instrumental and linear methods of body treatment.
authors.affiliation: Health Policy Research Center (HPRC), Shiraz University of Medical Sciences, Shiraz, Iran; ; Department of Sociology and Social Planning, College of Economics, Management, and Social Sciences, Shiraz University, Shiraz, Iran;
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kalateh Sadati
authors.affiliation: Department of Sociology and Social Planning, College of Economics, Management, and Social Sciences, Shiraz University, Shiraz, Iran;
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Iman
authors.affiliation: Health Policy Research Center (HPRC), Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Kamran
authors.initials: K
authors.lastname: Bagheri Lankarani
keywords: Clinic; Dependency; Doctor-Patient Relation; Political Economy