Recognition can leave room for disagreement in the doctor-patient consultation.

Abstract

OBJECTIVE: We 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. METHODS: We 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. RESULTS: The 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. CONCLUSION: Schibbye's ideas and terms can provide new perspectives on the doctor-patient interaction. PRACTICE IMPLICATIONS: For 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.