2005 - Volume 46 > Numéro 3

ISSN 0035-2969

Physicians, their patients and their peers : a new approach to the therapeutic relation
Patrick CASTEL

pp. 443-467


Studies of the therapeutic relation have until recently neglected a decisive aspect of it : relations among physicians. Research on these relations in the case of cancer treatment suggests a different understanding of the therapeutic relation. Competition among doctors with regard to medical activity and the matter of defining the right treatment is an additional source of uncertainty for a doctor in his or her attempt to maintain a grip on the relation with patients. Medical strategies for organizing and reorganizing specific patient in-take and care procedures at the local level may therefore be analyzed as attempts to reduce that uncertainty. Conversely, curing the disease is not the only aim of the doctor’s relation to his or her patients ; that relation is also a means of mastering uncertainty and thereby improving future therapeutic relations. For the doctor, the patient is a means of obtaining information on the way his or her fellow doctors behave and a means of exchange that enables the doctor to maintain particularly strong relations with some of his or her peers.



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