Heinrich M
Medizinische Soziologie Universität Freiburg, Medizinische Fakultät der Albert-Ludwigs-Universität Freiburg, Freiburg.
Gesundheitswesen. 2014 Jul;76(7):413-6. doi: 10.1055/s-0034-1374620. Epub 2014 Jun 26.
Due to developments of the health market, economic aspects of the health system are more relevant. In this upcoming market the patient is regarded as customer and the doctor as provider of medical services. Studies on customer orientation in the ambulant medicine lag behind this dynamic. An aim of the study is to comprehend the attitudes of the doctors referring to the customer orientation. In a second step the findings are discussed according to statements of health-care paticipants. Developments in role comprehension of doctor and patient are focused to gain results in scientific and practical applications.
Guideline-supported, partly narrative interviews with n=9 gynaecologists and n=11 general practitioners in Freiburg/Germany are recorded, transcribed and reviewed in a qualitative analysis.
The statements of the doctors show patient satisfaction has an incremental meaning sspecially regarding the sequence of patient relationship and economic management of the doctor's workplace. The doctor's role comprehension meets with a refusal of the role of salesman and the patient as customer.
The method of interviews is suitable to gather empirical impressions of the doctors. The control sample is adequate, however a bias due to inhomogeneous thematic affinitiy and local social-demographics might be possible. The customer orientation has become an important factor in doctor-patient relationtships. The relevance of the doctor-patient conversation and the risk of misuse of the patient confidence are mentioned by the doctors. The doctor as paternalistic care provider gives way to the customer-focused service provider. The doctor's necessity of autonomyssss and dependency on patient satisfaction have potential for conflict.
Intensive mention of customer orientation in medicine in the media emphasises its importance. Rational handling with the possibilities of individual health markets is a prospective challange. Further research could be established in all aspects of customer orientation, especially the changing relevance of ethical responsibility. An enlargement or comparison with other control samples (n>20, other medical subfields, structurally weak areas) could be illuminating. The results of this qualitative study can be used to develop quantitative inquiries.
由于健康市场的发展，卫生系统的经济方面变得更加重要。在这个即将到来的市场中，患者被视为客户，医生被视为医疗服务的提供者。门诊医疗中关于以客户为导向的研究落后于这种动态变化。本研究的一个目的是了解医生对以客户为导向的态度。第二步，根据医疗保健参与者的陈述对研究结果进行讨论。重点关注医生和患者角色认知的发展，以在科学和实际应用中取得成果。
在德国弗莱堡，对9名妇科医生和11名全科医生进行了指南支持的、部分为叙述性的访谈，并进行了记录、转录和定性分析。
医生的陈述表明，患者满意度具有递增意义，特别是在患者关系的顺序和医生工作场所的经济管理方面。医生的角色认知与对推销员角色和患者作为客户的拒绝相契合。
访谈方法适合收集医生的实证印象。对照样本是足够的，然而，由于主题亲和力和当地社会人口统计学的不均匀性，可能存在偏差。以客户为导向已成为医患关系中的一个重要因素。医生提到了医患对话的相关性以及滥用患者信任的风险。作为家长式护理提供者的医生让位于以客户为中心的服务提供者。医生对自主权的必要性以及对患者满意度的依赖存在冲突的可能性。
媒体对医学中以客户为导向的大量提及强调了其重要性。合理处理个人健康市场的可能性是一个潜在的挑战。可以在以客户为导向的所有方面进行进一步研究，特别是道德责任不断变化的相关性。扩大样本量或与其他对照样本（n>20，其他医学子领域，结构薄弱地区）进行比较可能会有启发。这项定性研究的结果可用于开展定量调查。
