From ‘directing them’ to ‘it's up to them’: The physician's perceived professional role in the physician−patient relationship

Abstract

One of the oldest goals of the medical profession is to benefit, and do no harm to, the patient. The role of the physician was once a paternal one, with total physician control, and little value given to patient knowledge of their own illness experiences. With changing patient expectations and medical education reform, patient-centeredness has emerged as a dominant ideal in doctor–patient communication. Patient autonomy is increasingly valued. In this changing time of increased patient involvement in medical decision making, how do physicians describe their professional roles/identities? Self-described professional identity is often quite reflective of professional beliefs and practice. The present study offers a qualitative perspective on self-perceived physician professional roles from primary care physicians of three age groups, in their 50s, 40s, and 30s. Younger physicians in the sample expect patients to have the most autonomy and most control over their decision making, while older physicians still expect to have the most control. It is possible that these age-based patterns of physician professional identity reflect an increasingly autonomous patient role and a decreasing role for physician beneficence. Implications and practical applications of these results for the medical interview will be discussed.