Recognition can leave room for disagreement in the doctor–patient consultation

Abstract

ObjectiveWe wanted to explore how recognising interaction, as described by psychologist Schibbye, is played out in a patient doctor encounter including the behaviour of both parties and their simultaneous communication. MethodsWe selected videotapes from five doctor–patient encounters where a recognising attitude was identified. The episodes were analysed using a qualitative method for studying interaction and relationship at the micro-level. We describe an episode which is suitable for demonstrating how a recognizing attitude can leave room for disagreement. ResultsThe doctor's recognising attitude with a basic respect for the other person's experience perspective has a crucial effect on the doctor–patient relationship. In this consultation, the doctor succeeds in taking the patient's experience perspective by listening, wondering and exploring to check that he has interpreted the patient correctly. A potential conflict situation arises, but there is no conflict. When the relationship is characterised by recognition, disagreement is allowed, without doing any damage. ConclusionSchibbye's ideas and terms can provide new perspectives on the doctor–patient interaction. Practice implicationsFor the doctor, a fundamental respect for the patient's perspective may make it easier to tolerate when patients have values and preferences that conflict with the doctor or with sound medical practice.