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Article
Publication date: 10 June 2021

Sergio Riotta and Manfredi Bruccoleri

This study formulates a new archetypical model that describes and re-interprets the patientphysician relationship from the perspective of two widespread phenomena in the…

Abstract

Purpose

This study formulates a new archetypical model that describes and re-interprets the patientphysician relationship from the perspective of two widespread phenomena in the healthcare delivery process: value co-creation (VCC) and defensive medicine (DM).

Design/methodology/approach

Grounded in the existing literature on VCC and DM, the authors designed and conducted 20 in-depth interviews with doctors (and patients) about their past relationships with patients (and doctors). After putting the recorded interviews through qualitative analysis with a three-level coding activity, the authors built an empirically informed model to classify patientphysician relationships.

Findings

The authors identified four archetypes of patientphysician relationships. Each archetype is described along with its representing characteristics and explained in terms of its consequences as they relate to VCC and DM.

Research limitations/implications

This research contributes to the literature on both VCC in healthcare and DM, in addition to the patientphysician's relationship literature.

Practical implications

Being aware of patientphysician relationship mechanics, building long-term relations with patients and investing in service personalization and patient-centred care can effectively mitigate the risks of DM behaviours on one side while increasing the likelihood of VCC actualization on the other.

Originality/value

Although strictly linked to the interactions between patients and doctors, VCC and DM are typically considered disentangled. In this research paper, the authors identified four archetypes of patientphysician relationships in relation to these two phenomena.

Details

Journal of Service Theory and Practice, vol. 31 no. 6
Type: Research Article
ISSN: 2055-6225

Keywords

Article
Publication date: 1 September 2006

Robyn Ouschan, Jillian Sweeney and Lester Johnson

Several trends such as improved access to health care information via the internet, the growth of self‐help groups and expenditure on alternative medicine signals…

7329

Abstract

Purpose

Several trends such as improved access to health care information via the internet, the growth of self‐help groups and expenditure on alternative medicine signals consumers are taking an active role in their own health management. Chronic illnesses such as diabetes and asthma require a significant amount of self‐management and thus call for a collaborative patientphysician relationship. This study explores whether empowering patientphysician consultations measured through three patient empowerment dimensions (patient control, patient participation, physician support) enhance patients trust in and commitment to their physician.

Design/methodology/approach

A comprehensive mail survey of adults registered with one of four different chronic illness associations in Australia was conducted to collect the data.

Findings

The structural equation modelling results show that patients are more trusting of and committed to physicians who adopt an empowering communication style with them.

Research limitations/implications

This study focuses on the Australian healthcare context. Thus, future multinational studies should explore suitable strategies to empower healthcare consumers that build on the constraints placed by diverse healthcare systems.

Practical implications

In a managed health care and cost cutting climate where patient trust is deteriorating, these findings suggest that empowering patients presents a means to improve the patientphysician relationship.

Originality/value

Whilst numerous marketing scholars have researched the empowerment of staff, there is a shortage of studies that address the meaning and outcomes of consumer empowerment. This study proposes a unique communication based consumer empowerment construct which is shown to impact on consumer‐service provider relationships.

Details

European Journal of Marketing, vol. 40 no. 9/10
Type: Research Article
ISSN: 0309-0566

Keywords

Article
Publication date: 11 May 2015

Elena A. Platonova and Richard M. Shewchuk

The purpose of this paper is to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient

Abstract

Purpose

The purpose of this paper is to examine how patient assessment of primary care physician (PCP) communication is related to patient satisfaction with the PCP, patient perception of PCP professional competence, patient assessment of the relationship with the doctor and patient demographic characteristics using a segmentation approach.

Design/methodology/approach

The authors surveyed 514 adult patients waiting for appointments with their PCPs in two US primary care clinics. A latent class analysis was used to identify mutually exclusive unobserved homogeneous classes of patients.

Findings

The authors identified three distinct classes/groups with regard to patient assessment of physician communication and the physician-patient relationship. The largest group (53 percent of the sample) assessed their PCP communication and other doctor-patient relationship aspects as excellent. However, 37 percent provided mostly negative assessments, expressed high general dissatisfaction with the physician and disagreed with the statement that their PCP was well qualified to manage their health problems. These patients were on average more educated and affluent and the group included more males. About 10 percent of patients expressed generally lower satisfaction with the PCP, though their dissatisfaction was not as extreme as in the highly dissatisfied group.

Research limitations/implications

Further studies are needed to help physicians develop skills to communicate with different patients.

Originality/value

Patient segmentation can be an important tool for healthcare quality improvement particularly for emerging approaches to primary care such as patient-centered care.

Details

International Journal of Health Care Quality Assurance, vol. 28 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Book part
Publication date: 21 December 2010

Victor Lidz

Chapter X of The Social System is often cited as the “charter” for the specialty field of medical sociology. A notable feature of its analysis is the argument that the…

Abstract

Chapter X of The Social System is often cited as the “charter” for the specialty field of medical sociology. A notable feature of its analysis is the argument that the physician is an agent of social control in relation to the patient. This argument grounds the application to medical practice of Parsons’ general conception that social control is an aspect of all social relationships. Parsons started by addressing the situation of a patient who assumes the sick role and then becomes the patient of a physician. The sick role involves a suspension of at least some of the performance expectations associated with a person's everyday social life, such as expectations of working productively at one's job, attending the meeting of a civic association, or caring for one's family members. But in assuming the sick role, an individual encounters new expectations that he or she should try to get well. For minor illnesses this may involve only resting, drinking fluids, and avoiding stress. For more serious illnesses, given our culture's valuation of scientific medicine, it typically involves placing oneself in the care of a physician. It then becomes the physician's duty to offer treatment and guidance to restore one's health and enable one to return to meet expectations of everyday roles. Thus the physician becomes an agent of social control.

Details

Social Control: Informal, Legal and Medical
Type: Book
ISBN: 978-0-85724-346-1

Article
Publication date: 19 March 2021

Mumin Dayan, Ibrahim A. Al Kuwaiti, Zafar Husain, Poh Yen Ng and Aysenur Dayan

The aim of this research is to uncover issues that inhibit patients' satisfaction and loyalty and identify factors that could enhance customer retention by government…

Abstract

Purpose

The aim of this research is to uncover issues that inhibit patients' satisfaction and loyalty and identify factors that could enhance customer retention by government hospitals in the United Arab Emirates (UAE). The mediating impact of outpatient satisfaction on service quality, word of mouth (WoM), hospital image, outpatient–physician relationship and outpatient loyalty were tested.

Design/methodology/approach

The sample data used to test the hypotheses were drawn from a pool of patients served by a government healthcare agency in Abu Dhabi. Questionnaires were provided to 418 participants using methods such as short message service, e-mail and face-to-face delivery. The data were analyzed using SmartPLS 3.3.2 software.

Findings

The results indicate that service quality, WoM and outpatient–physician relationship positively impact outpatient satisfaction and indirectly effect outpatient loyalty; that hospital image positively impacts outpatient satisfaction and loyalty and has a partially mediating effect on loyalty; that waiting time satisfaction has no effect on outpatient satisfaction and no moderating effect on the outpatient satisfaction–loyalty relationship and that switching cost has a positive effect on loyalty but no moderating effect on the outpatient satisfaction–loyalty relationship.

Research limitations/implications

The first limitation of this study concerns the fact that only patients who had previously been served by these hospitals' outpatient units were included. Furthermore, the research was not able to obtain extensive findings related to the various factors that negatively impacted patient satisfaction and loyalty among all of the departments of government hospitals, such as inpatient care and emergency care.

Practical implications

Centered on the findings from this research, increasing switching costs would prevent patients from switching to other healthcare providers. Therefore, it has the potential to create a false loyalty or a hostage customer (Jones and Sasser, 1995). Additionally, making patients feel connected to their treatment plan and engaged in their care by developing a tool to maintain their enthusiasm about their health is important. It is therefore recommended that government hospital care providers and management consider providing online tools that patients can use to self-manage their care.

Social implications

The results regarding patients' satisfaction level suggest several areas for improvement. The first pertains to waiting area entertainment and comfort because patients indicated that there is not enough entertainment or ways to pass the time when waiting for services. In addition to enhancing the entertainment and comfort of waiting areas, government hospital staff should maintain contact with patients who are waiting to ensure that they are aware of the time they will spend. Another area for improvement is the parking lot. During summer, patients prefer to walk less in the sun, which causes them to seek parking closer to the door. Government hospital management should consider different methods for transporting patients closer to the door, such as golf carts or valet services.

Originality/value

This is the first study to investigate the mediating impact of outpatients' satisfaction between its antecedents and loyalty in the UAE. These results provide an improved understanding of the factors influencing patient choices and establish more accurate methods for increasing patient loyalty to retain more patients.

Details

International Journal of Quality & Reliability Management, vol. 39 no. 1
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 30 October 2019

Adelaide Ippolito, Francesco Smaldone and Margherita Ruberto

The purpose of this paper is to develop a research framework for exploring and improving patient empowerment through the analysis of the effects produced by a satisfying…

Abstract

Purpose

The purpose of this paper is to develop a research framework for exploring and improving patient empowerment through the analysis of the effects produced by a satisfying physician relationship on patient involvement in the healthcare process.

Design/methodology/approach

The authors begin with a literature review of patient empowerment in healthcare, useful to highlight the importance of relational aspects. Then, the authors tested the hypotheses of the research through the analysis of 450 questionnaires. The results are analyzed through covariance-based structural equation modeling.

Findings

This paper highlights how empowerment is a more complex phenomenon, needing many dimensions to be investigated. The hypotheses were tested, and correlations computed, highlighting a medium-strong positive correlation between physician relationship and patient involvement determining satisfying patient empowerment.

Research limitations/implications

The considerations conducted in the paper are restricted to physician relationship and needs further research aimed to analyze and evaluate the changes in the patient behaviors influenced by empowerment.

Practical implications

The research points offer new insight into patient empowerment and allow the healthcare provider to create new opportunities for promoting patient empowerment through the development of quality relationship for effective patient involvement.

Originality/value

The study developed contributes new insight about patient empowerment in the healthcare management literature, proving the key role of satisfying physician relationship useful for future researches.

Details

The TQM Journal, vol. 32 no. 1
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 5 September 2016

Mahmoud Abdulai Mahmoud

The purpose of this paper is to explore the extent of consumer trust of physicians’ prescription of branded medications.

Abstract

Purpose

The purpose of this paper is to explore the extent of consumer trust of physicians’ prescription of branded medications.

Design/methodology/approach

This paper adopts a qualitative research approach to study consumers’ self-reported experiences with respect to their trust in physicians’ prescription of branded medications. An open-interview approach and a focus group discussion were adopted in collecting research evidence from a sample of middle-level executives from various Ghanaian industries who have experienced physicians’ prescription of branded medications.

Findings

Consumers have mix reactions toward physicians’ prescriptions of branded medicines. Whereas some trust, others are uncertain, while some do not trust physicians at all. The last group believes the physicians are serving the interest of third parties in prescribing branded medications.

Research limitations/implications

This study focuses only on patients’ perspectives. This research could be widened to include other important stakeholders of healthcare delivery such as physicians, pharmacists and management of health institutions.

Practical implications

The study provides a platform for physicians to appreciate the trust their clients repose in them as they prescribe medication to them.

Social implications

It is envisaged that the research will assist consumers of branded medications to probe into why branded medications are insisted on to be purchased instead of alternatives.

Originality/value

This study provides further perspectives on consumer reactions to physicians’ prescription of branded medications.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 10 no. 3
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 1 September 1996

Joby John

Examines the “dramaturgical” view of the service encounter to understand the service consumption experience. Illustrates this by demonstrating how the drama metaphor is…

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Abstract

Examines the “dramaturgical” view of the service encounter to understand the service consumption experience. Illustrates this by demonstrating how the drama metaphor is applicable and useful in understanding perceived quality in health care services. Presents a strategic model of the medical encounter. Suggests impression management guidelines and, from a practical standpoint, serves to stimulate the imaginations of physicians and health care administrators on managing evaluations by paying attention to certain characteristics of the medical encounter.

Details

European Journal of Marketing, vol. 30 no. 9
Type: Research Article
ISSN: 0309-0566

Keywords

Book part
Publication date: 10 February 2010

Jane Cote and Claire Kamm Latham

Building on prior research linking stakeholder relationship quality with financial performance, we explore interorganizational engagement from a bilateral perspective…

Abstract

Building on prior research linking stakeholder relationship quality with financial performance, we explore interorganizational engagement from a bilateral perspective, more fully representing the dynamics within an alliance. Interorganizational relationship quality and stakeholder management theory in healthcare and in accounting research provide the foundation for these insights.

While the study's findings demonstrate consistent views regarding the importance of relationship management and patient care, the two stakeholder groups hold divergent perspectives on how to accomplish these goals. Insurance executives take a population perspective, whereas physician practices focus their decision making at the patient level. The relative power and size between stakeholders was instrumental in how insurers chose to develop relationships with individual physician practices. These findings provide the nucleus for understanding reported frictions.

Details

Advances in Management Accounting
Type: Book
ISBN: 978-1-84950-755-4

Book part
Publication date: 6 December 2005

Michael Rothberg

From the very beginning of medical practice, physicians have enjoyed a degree of autonomy which exceeds that of almost any other profession. Although regulated by state…

Abstract

From the very beginning of medical practice, physicians have enjoyed a degree of autonomy which exceeds that of almost any other profession. Although regulated by state medical boards, and limited by the threat of litigation, physicians are generally held in high esteem by society and allowed to practice medicine as they see fit. Physicians have usually been allowed to prescribe any drug for any disease, including the so-called “off-label” uses for which Food and Drug Administration (FDA) approval has not been obtained. They can also use new or untested medical devices and surgical procedures, as long as they obtain informed consent from the patient. Society has trusted doctors to do the right thing for their patients, and thus tried not to interfere with the sacred doctor–patient relationship.

Details

Crisis and Opportunity in the Professions
Type: Book
ISBN: 978-1-84950-378-5

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