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Qualitative Health Research
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Power Imbalance and Consumerism in the Doctor-Patient Relationship: Health Care Providers’ Experiences of Patient Encounters in a Rural District in India

Grethe Fochsen

Department of Public Health Sciences, Division of International Health, Karolinska Institutet, Sweden

Kirti Deshpande

Department of Community Medicine, R. D. Gardi Medical College, Ujjain, India

Anna Thorson

Department of Public Health Sciences, Division of International Health, Karolinska Institutet, Sweden

The aim of this study is to explore health care providers’ experiences and perceptions of their encounters with male and female patients in a rural district in India with special reference to tuberculosis (TB) care. The authors conducted semistructured interviews with 22 health care providers, 17 men and 5 women, from the public and private health care sectors. Findings reveal that doctors adopted an authoritarian as well as a consumerist approach in the medical encounter, indicating that power imbalances in the doctor-patient relationship are negotiable and subject to change. Gender was identified as an influencing factor of the doctor’s dominance. A patient-centered approach, acknowledging patients’ own experiences and shared decision making, is called for and should be included in TB control activities. This seems to be especially important for female patients, whose voices were not heard in the medical encounter.

Key Words: doctor-patient relationship • consumerism • gender • tuberculosis • India

Qualitative Health Research, Vol. 16, No. 9, 1236-1251 (2006)
DOI: 10.1177/1049732306293776
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