Problems in doctor-patient communication: The case of younger women with breast cancer

Abstract

Communication between physicians and patients is considered to be a core component in the provision and receipt of appropriate medical care. However, previous research indicates that doctor-patient relationships can be problematic, with negative consequences for patients including higher levels of anxiety, distrust of medical providers, dissatisfaction with healthcare and lower quality of life. This research utilizes data collected from a series of focus groups involving 19 women with breast cancer aged 50 and under to examine the nature of problems that may arise in communication between physicians and younger patients concerning the detection, diagnosis and treatment of this life-threatening disease. Conducted according to the general principals of grounded theory generation, this analysis identified four central themes: (1) women's realization of medical uncertainty, (2) their rejection of physician paternalism, (3) women's desire for information, and (4) their preference for a greater role in decision making. Qualitative data are presented in the context of social influences and cohort experiences that help to explain these difficulties. The results suggest that communication problems may be a consequence of incongruity between medical practice and patient expectations. Medical uncertainty regarding breast cancer in pre-menopause can lead to recognition of physician fallibility and rejection of expert authority. Socialized in an era of increasing patient autonomy and medical consumerism, results indicate that this cohort of women tends to prefer an active partner to passive patient role in the diagnostic and treatment decision-making process.