Patient Power in Doctor-Patient Communication: What Do We Know?

Power in relationships between doctors and patients has undergone scrutiny as interest in medical consumerism and patients' rights has increased. Transfer of expert power from doctor to patient may be accomplished in the medical encounter. Research has documented the effects of sociodemographic factors, attitudes, and situational variables on patients' attempts to influence doctor-patient encounters. Additional studies have explored the effects of active patient participation in medical encounters with emphasis on patient information-seeking activities, patient assertiveness, and patient input in medical decision making. Patients desire information, but make few attempts to elicit it from doctors, although they can be trained to do so. Even though they feel they have a right to challenge a doctor's authority, few patients ever do. Some patients desire to participate in medical decisions; others do not. Implications for the doctor-patient relationship are discussed.