Salmon P, May C R
Department of Clinical Psychology, University of Liverpool, United Kingdom.
Int J Psychiatry Med. 1995;25(4):319-29. doi: 10.2190/JUNY-QCER-GWLF-H60R.
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.
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.
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.
大量实证数据和理论描述了医生与患者关系中权力的不平等。然而，重点一直放在医生控制医患关系的方式上。这意味着患者影响诊疗过程的程度以及他们这样做的方式一直被忽视。
在本文中，我们通过一个案例来识别和阐述患者运用权力决定诊疗结果的不同方式。
这种分析得出了一个比目前可用的解释更有力的结论，以理解心理需求的躯体化。据此，患者围绕生物医学模式组织策略，其中包括呈现情感和社会困扰。由于医生对自身角色的先前决定，他们让自己陷入了这个模式。
