Your Diabetes
Your Diabetes
U. S. Health Care Providers’ Orientations toward Patients
This chapter uses interview data with American health care providers to examine clinicians’ strategies for negotiating with patients to elicit cooperation and participation in their own self-management. It argues that physicians in both countries switch between different models of the provider-patient relationship as they see fit to the situation. The American providers stressed that, ultimately, responsibility for managing the disease rested with the patient. However, they were markedly pessimistic about their patients’ capacity for change and likely course of disease progression. Providers’ low expectations and pessimism contributed to a preference for small, simple lifestyle changes in combination with medication rather than bold lifestyle change.
Keywords: Patient-centered medicine, Paternalism, Clinician pessimism, Strategies for clinical management, Individual responsibility
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