Doctor-Patient Relationship: The Difficult Balance between Patient Psychology and Community Sociology

Psychology and sociology share a common object of study, human behaviour, but from different perspectives. Sociologists have focused on macro variables, such as social structure, education, gender, age, race, etc., while psychology has focused on micro variables such as individual personality and behaviours, beliefs, empathy, listening, etc. Despite the importance of interpersonal relationship skills, they depend on the community or social context in which communication takes place, and by themselves may have little relevance in the consultation. The purely psychological analysis of the doctor-patient relationship often leads to an idyllic vision, with the patient-centred consultation as the greatest exponent, which rarely occurs in real life. The purely sociological or community / social analysis of the doctor-patient relationship leads to a negative view of the consultation, which is always shown as problematic. But, the psychological system in the doctor-patient relationship cannot be neglected, and its study is of importance, at least as an intermediate mechanism that is created through socio-community relations. Although the same social causes are behind the doctor-patient relationship, when acting on psychological factors in the consultation, they act as an optical prism scattering socio-community relations that affect the doctor and the patient, giving rise to a beam of different colors of doctor-patient relationship. In doctor-patient relationship there is a modality of psychotherapy, where attitudes, thoughts and behaviour of the patient, can be change, as well as it can be extended on the way of understanding and therefore changing, his social context. Because of the distance between socio-community relations and the form of doctor-patient relations is growing in complex societies, under these conditions, the sociological factor gives the important place to the psychological factor. Given these difficulties of the doctor-patient relationship one may ask how general medical practice can persist with the usual model of doctor-patient relationship. Pain and the desire to relieve them are the basic reasons for the patient and the doctor, and they do not disappear due to the contradictions of the doctor-patient relationship. In this way, the confrontation between sociological and psychological vision is replaced by an alliance of both currents, and each of them takes on meaning only in the general vision.