Improving the impact of health services delivery: The relationship between physician and patient in the Aravind Eye Care System Outreach Camp Project in Rayavaram, India
Abstract
This paper investigates the relationship between physician and patient at an outreach
eye camp in Rayavaram, Tamilnadu, India. This outreach eye camp represents free ophthalmic
care delivery to a rural, medically underserved population (n=32). In order to distinguish
the effects of two different determinants (rural vs. urban setting and free vs. full
cost care), the study included two additionally patient cohorts: urban, non-paying
patients (n=33) and urban, paying patients (n=30). Audio recordings and interviews
constituted data collection methods. The three components of a doctor-patient relationship
that were studied through these data were power dynamics, treatment decision-making,
and communication.
Results indicate that the doctor-patient relationship in a rural, non-paying setting
is characterized by a paternalistic power dynamic, paternalistic treatment decision
making model, and moderately effective communication. This means that medical consultations
were largely driven by the physician and fostered little patient control. The physician
alone made decisions about treatment (when choices were available). Furthermore, there
was a moderate level of communication from doctor to patient about the diagnosis and
treatment protocol. Lastly, each consultation was largely a one-sided exchange as
it offered little opportunity for the patient to express concerns or ask questions.
Though medicine of the western world has increasingly come to embrace the concept
of patient-centered medicine, the study discusses the harm associated with activating
rural, poor patients who are ill-equipped to take personal health into their own hands.
The study hopes that this understanding of the doctor-patient relationship will lay
the groundwork for future research and inform strategies to enhance this interaction,
thereby improving health outcomes of global health development projects.
Type
Honors thesisDepartment
Program IISubject
doctor patient relationshippatient centered medicine
patient activation
rural poor population
global health in india
eye health
Permalink
https://hdl.handle.net/10161/4956Citation
Veerappan, Malini (2011). Improving the impact of health services delivery: The relationship between physician
and patient in the Aravind Eye Care System Outreach Camp Project in Rayavaram, India.
Honors thesis, Duke University. Retrieved from https://hdl.handle.net/10161/4956.Collections
More Info
Show full item record
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Rights for Collection: Undergraduate Honors Theses and Student papers
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info