The Clinical Encounter and the Problem of Context

Abstract

The encounter between professional and patient is one of the basic units of analysis in the field of ‘medical’ sociology. From the very beginnings of the sociological investigation of medical practice it has been conceived as a dyadic encounter, defined by asymmetries of power, the negotiation of rational and authoritative scientific knowledge, and private, proximal, relations. This article argues for a more dynamic theoretical vision of the clinical encounter: one that shifts attention away from a Parsonian ‘paradigm’ of professional–patient interaction towards a perspective that incorporates the systemic changes that late modernity brings to medicine.The clinical encounter is no longer the dyadic system envisaged by Parsons, and his theoretical perspective–which has played an important part in framing sociological accounts of the practice of medicine – now needs to be reframed in relation to the organizing impulses of contemporary corporate professional practice.