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, th e focus has been on the ways in which doctors control the doctor-patie nt relationship. This has meant that the extent to which patients infl uence 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 determin e the outcome of consultations. Conclusion: This analysis leads to a m ore powerful explanation than is presently available to understand the somatization of psychological needs. According to this, the patient o rganizes strategies, which include the presentation of emotional and s ocial distress, around a biomedical model. Because of their prior deci sions as to their role, doctors permit themselves to be trapped in thi s model.