Relationship Patterns Between Surgeons and Heart Surgery Patients in a Thai Cultural Context

Abstract

     This qualitative study focused on relationship patterns between surgeons and heart surgery patients. The study site was a central hospital in Eastern Thailand. Data were collected from December 2011 to May 2012, mainly through narrative interviews with 7 patients and semi-structured interviews with 68 patients (altogether 75 patients), all of whom had undergone coronary artery bypass grafting surgery, and also through participant observation. The validity of the data was checked using data triangulation from interviews with patients, in-depth interviews with medical experts, and medical chart record reviews. The findings indicated that there were various kinds of power inequalities between the patients and the surgeons in a Thai cultural context. Firstly, the patients’ health was in a critical condition, so the surgeons’ role was that of life savers. They were trusted to make decisions over the patients’ lives and they had the power to use medical technology while operating on the patients’ hearts to save their lives. Secondly, the surgeons were in a position of superiority toward their patients; they prescribed treatments the patients had to accept. Thirdly, the surgeons also had a role as merchants and the patients as customers, as capitalism played an important role in the treatment of heart disease and heart surgery in private hospitals. These findings reflect relationship patterns between surgeons and heart surgery patients from the patients’ point of view. The findings can be used to improve the balance of power between physicians and patients in health services.