Intimate Adversaries

Effective communication between doctors and patients is essential to good health care, yet patients increasingly complain of impersonal, overly technical medical treatment. Physicians, on the other hand, report that their patients have unrealistic expectations and ignore recommendations. Problems in doctor-patient communication increase when the patient is a woman. Social values and attitudes toward reproduction, women''s bodies, and femininity are powerful, if subtle, influences on health care delivery.

For over two years, Alexandra Dundas Todd audiotaped and observed communications between gynecologists and observed communications between gynecologists and women patients in a private practitioner''s office and in a community clinic. Intimate Adversaries provides a close-up view of what takes place in medical interactions centered on reproductive care. Todd is especially sensitive to the difficulties caused by the different perspectives of doctor and patient. Whereas doctors usually concentrate on a biomedical approach, patients view their biological concerns as embedded in broader contextual experiences. Women tell stories about their health and reproduction to communicate these comprehensive concerns. When the stories are ignored, the women are at risk of receiving inadequate medical care.

Writers in political economy and feminist theory have contributed in-depth studies of society and medicine. Less has been said about the relation ship among the epistemological roots of science, the development of the medical model, the treatment of women patients, and influences on diagnostic decision-making. It is the relationship of a scientific world view to modern medicine and to women, as well as analyses of specific interactions, that are the core of this book.