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June 21, 1985

Medicine and the Management of Living: Taming the Last Great Beast

JAMA. 1985;253(23):3469-3470. doi:10.1001/jama.1985.03350470123039

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No observer can avoid some interest in the rapidly changing world of physician-patient encounters. Arney and Bergen provide us with a fresh and provocative analysis of this change.

The authors seem content with the traditional sociological view that it is useful to examine the distribution of power in the physician-patient relationship, but they are critical of the lack of attention to language as a means by which the reality of the patient's experience is created and displayed in the encounter. Borrowing heavily from the French sociologist Michael Foucault, the authors find it useful to frame "power" in a new sense of work mutually accomplished by persons in social situations rather than in the traditional sense of unilateral "exclusionary practices."

The authors argue that contemporary thought would have us believe that patients are in the process of achieving a liberation through political work and the assertive acquisition of medical knowledge in