Essay about Qualitative Exploratory Study: The Doctor-Patient Relationship

The doctor-patient relationship demonstrates many differences from a researcher-subject relationship. The two relationships diverge when it comes to the purpose of the interaction, the interaction itself between professional and patient or subject, and the final goal that results. The basis of the differing relationships stems from the contrast in the moral obligations and responsibilities that each professional is required to uphold, and this in turn affects the kind of relationship that exists between a doctor and patient or a researcher and research subject.

Branch (2014) presented a perspective piece that laborated on the development of a humanistic relationship between doctors and patients. Zvonareva and Akrong (2015) gave insight into the relationship between clinical investigators and research participants through a qualitative exploratory study. In this study, I will summarize, compare, and critique the two articles for any commonalities and differences between the two relationships.

Zvonareva and Akrong’s (2015) qualitative exploratory study expanded on the investigator-participant relationship by focusing mainly on “what kinds of relationships were actually eing built and how; what kind of roles and responsibilities were expected and constructed; and what were the ensuring consequences” (p. 259). Individuals from two separate demographic pools received the interviews: 20 participants in Ghana and 24 in South Africa. The participants in each country divided further into two sections: those who had no prior personal experience with clinical research and those that did.

The in-depth interviews led by Akrong in Ghana and Zvonareva in South Africa had questions concerning the meaning, purpose and experiences of clinical research, the discerned roles of articipants and researchers, and the relationship between them. The following results found that subjects who had no prior experience termed participating as ‘helping. ‘ Several interviews supported this as there was an overlap in responses with the shared view that the purpose of research subjects was to help the researchers conduct studies.

Participants with prior experience in clinical trials described their relationship with researchers as one of mutuality, referring to the concept of a ‘team. ‘ Respondents of the interviews felt strongly that in order o participate in clinical trials, there needed to be a mutual level of respect, understanding, and communication. The researchers concluded that the overall perspective that linked the participants interviewed was that they viewed themselves as equals to investigators. Mutuality and respect were critical in pursuing “equal partnership” (pg. 62). Zvonareva and Akrong’s (2015) method of issuing interviews specifically addressed responses that could be different due to geographical placement. Clinical research was already familiar in South Africa and still fairly new in Ghana. This made up for any discrepancies in the participants’ perspectives of the researcher-subject relationship that could have occurred due to how exposed they have been to the concept before. The interview process also occurred at the two different stages of no experience and with past experience.

Through this process, the researchers were able to distinguish between perspectives of the research-subject relationship that have occurred due to past experience with clinical research itself. While the two placements in Zvonareva and Akrong’s (2015) study is a strength in the aspect that it ncluded two test groups, the geographic locations are also a source of weakness. The interviews were conducted among a population that claimed to be “aware of the poor health of many citizens in South Africa and Ghana… (p. 261) This socio- economic factor places a certain bias in the ways participants may have responded, especially evident in the emphasis on a need to participate in trials in order to better local health. While not particularly a problem in this study itself, note that this perspective could be subject to change when placed in different geographical settings. Another discrepancy is observed in how Zvonareva and Akrong interviewed their given respondents separately.

Because the research methodology was in the form of interviews, the questions given and how they were given required consistency in order to form solid correlations. The conclusions based on the research are relevant in that there is significant overlap in answers that point to one overall concept. However, a more aligned and consistent research methodology could support a stronger conclusion. Branch’s (2014) perspective article largely centers around how the doctor- atient relationship has developed in the last few decades.

The methodology involved incorporated both his own past experiences as a medical doctor and relevant literature to affirm the idea that in recent decades, medicine has changed its practice in the way that physicians formulate relationships patients. He began with an introduction to the history of the doctor-patient relationship and the transition that took place, from looking at patients objectively at a distance, to “providing more humanistic care and knowing the whole patient” (p. 68).

With an advancement of technology in the 1980’s, doctors had to “face the fact that biomedical science could not supply all the answers” (p. 68). By recalling past observations, Branch (2014) claimed the best clinicians were the ones who were genuinely kind and understanding, took into account of the patient’s needs, and kept honest lines of communication. The characteristics outlined draw a parallel to Zvonareva and Akrong’s (2015) study in how research subjects expected a mutual level of respect, understanding, and communication in order to properly participate in clinical trials.

Another aspect in which Branch (2014) based his findings was the concept of adjusting to patients’ needs. The need for adjustment on the patients’ end connected to Zvonareva and Akrong’s (2015) findings for the need of a shared perspective between investigators and research subjects to work together towards a common goal. Patients’ needs for the doctors to adjust their perspective in order to fully empathize with their patients reflects clinical participants’ needs for the investigators to share a common goal with them in order to collaborate smoothly.

The ey factor Branch (2014) pointed out was the need for trust to allow for patients to confide in their physicians – the crucial element to this being the doctors’ need to make promises they can keep. This coincides with the idea in Zvonareva and Akrong’s (2015) study that accountability is being fulfilled through general feedback on research progress and results. In both studies, trust is the major key factor in the relationships between professionals and patients or research subjects. The fact that Branch’s (2014) article draws so much from past experience esults in both a great strength and a detrimental weakness.

His narration through personal stories provides a strong base of real evidence that can be linked to the outcomes he makes claims over. From a personal standpoint, he makes a convincing argument that is intuitively sound both ethically and morally. However, for the same reasons, the personal accounts make it difficult to generalize his findings to the universal concept of a doctor-patient relationship because what Branch (2014) fails to do is provide more scientifically sound evidence. The study could be better generalized to the wider population if he ncluded the perspective of other physicians and patients.

Making a scientifically convincing case is difficult when there is only one voice, and thus one perspective, presented. Branch (2014) does attempt to find closure in his findings through literature citations but including more outright perspectives would result in a stronger argument in his overal| conclusion about the doctor-patient relationship. Despite relev differences in a doctor-patient relationship and researcher- subject relationship, comparisons between Zvonareva and Akrong (2015) and Branch’s (2014) studies show that there are lso many similarities that can be drawn between the two.

Even with the differing end goals, both roles of patient and research subjects demand the same in terms of respect, care, trust, and communication to reciprocate mutual feelings back, allowing for the relationships to hold. Living in a time where technological advances are being made every day in medicine and science, there is importance in not forgetting the human interactions that have made these advances possible. Science cannot get ahead of morality and ethics in our modern society that depends on healthy and safe relationships.