Author Affiliations: Department of Social and Behavioral Sciences (Dr Ackerman), Department of Epidemiology and Biostatistics (Dr Auer), and Division of General Internal Medicine, Department of Medicine, and Department of Epidemiology and Biostatistics (Dr Gonzales), University of California, San Francisco.
Current research on patient-clinician communication points to the persistent challenge of realizing the principles of “shared decision making.” The recent report titled “Communicating with Physicians About Medical Decisions: A Reluctance to Disagree,” for example, suggests that even socioeconomically advantaged, highly “activated” patients are reluctant to express disagreement with a physician.1 The same patients reported that they would be comfortable asking questions and discussing their preferences with physicians. The question of what makes certain practices and forms of speech possible for different types of people in particular contexts was addressed in rich detail some 40 years ago by the French sociologist Pierre Bourdieu. We hope that by offering a brief glimpse into the treasure chest of Bourdieu's theories about human behavior, a “new” way of understanding patient-clinician communication will be made available to interested readers.
Ackerman S, Auer R, Gonzales R. Cultural Capital: Accounting for Power in Patient-Physician Interactions. JAMA Intern Med. 2013;173(5):393-394. doi:10.1001/jamainternmed.2013.2167