Affective Behavior and Perceptions of Health Professionals

  • Zeev Ben-Sira


The first part of this chapter will probe into the accumulating evidence regarding the significance of physicians’ “affective” (humane, person-oriented) behavior for the patients’ well-being. That has been explained by the patients’ likelihood to assess the quality of the treatment on the basis of the doctors’ affective behavior, due to their inability to judge both the meaning of their somatic disturbance and the doctors’ competence. The first part of this chapter addresses the question as to whether this type of layperson’s assessments both of the effectiveness of the technical (instrumental) medical activities and of the physician’s competence are dependent on the physician’s formal qualifications (i.e., certified “specialists” vis-à-vis “generalists”) and on the seriousness (verified professionally) of the patient’s health condition (i.e., chronic disease). The second part summarizes accumulating evidence regarding physicians’ likelihood both to recognize the therapeutic importance of, and to engage in affective behavior as a component of the medical intervention.


General Practitioner Professional Competence Private Practitioner Affective Behavior Sick Person 
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  1. Antonovsky, A. (1979). Health, stress and coping. San Francisco: Jossey-Bass.Google Scholar
  2. Balint, M. (1957). The doctor, his patient and the illness. New York: International Universities Press.Google Scholar
  3. Balint, M., Hunt, J., Joyce, D., Marinker, M., & Woodcock, J. (1970). Treatment and diagnosis. Philadelphia: Lippincott.Google Scholar
  4. Ben-Sira, Z. (1972). The doctor-patient relationship: Collectivism or exchange. Unpublished Ph.D. dissertation. Jerusalem: The Hebrew University [in Hebrew].Google Scholar
  5. Ben-Sira, Z. (1976). The function of the professional’s affective behavior in client satisfaction: A revised approach to social interaction theory. Journal of Health and Social Behavior, 17, 3–11.PubMedCrossRefGoogle Scholar
  6. Ben-Sira, Z. (1980a). Affective and instrumental components in the physician-patient relationship: An additional dimension of interaction theory. Journal of Health and Social Behavior, 21, 170–180.PubMedCrossRefGoogle Scholar
  7. Ben-Sira, Z. (1980b). Involvement with a disease and primary care utilization. Sociology of Health and Illness, 2, 247–276.PubMedCrossRefGoogle Scholar
  8. Ben-Sira, Z. (1982a). Lay evaluation of medical treatment and competence: Development of model of the function of the physician’s affective behavior. Social Science and Medicine, 16, 1013–1019.PubMedCrossRefGoogle Scholar
  9. Ben-Sira, Z. (1982b). Stress potential and esotericity of health problems: The significance of the physician’s affective behavior. Medical Care, 20, 414–424.PubMedCrossRefGoogle Scholar
  10. Ben-Sira, Z. (1984). Chronic illness, stress and coping. Social Science and Medicine, 18, 725–736.PubMedCrossRefGoogle Scholar
  11. Ben-Sira, Z. (1985a). Primary medical care and coping with stress and disease: The inclination of primary care practitioners to demonstrate affective behavior. Social Science and Medicine, 21, 485–498.PubMedCrossRefGoogle Scholar
  12. Ben-Sira, Z. (1985b). Potency: A stress buffering link in the coping-stress-disease relationship. SocialScience and Medicine, 21, 397–406.CrossRefGoogle Scholar
  13. Ben-Sira, Z. (1986a). Stress, disease and primary medical care. Aldershot, England: Gower.Google Scholar
  14. Ben-Sira, Z. (1986b). The plight of primary medical care: The problematics of committedness to practice. Social Science and Medicine, 22, 699–712.PubMedCrossRefGoogle Scholar
  15. Ben-Sira, Z. (1986c). The stress resolving component in primary medical care. Stress Medicine, 2, 339–348.CrossRefGoogle Scholar
  16. Ben-Sira, Z., & Kacen, L. (1988). Stressbewältigung bei chronischer Krankheit: Gruppengespräche und Zuwendung des Arztes aus der Sicht der Sozialarbeit. In C. Mühlfeld, H. Oppl, H. Weber-Falkensammer & W. R. Wendt (Eds.), Brennpunkte Sozialer Arbeit (pp. 69–84). Frankfurt am Main: Diesterweg.Google Scholar
  17. Betz, M., & O’Connel, L. (1983). Changing doctor-patient relationships and the rise in concern for accountability. Social Problems, 31, 84–95.CrossRefGoogle Scholar
  18. Cartwright, A. (1976). What goes on in the general practitioner’s surgery? In M. Acheson & L. Aird (Eds.), Seminars in community medicine (Vol. I, pp. 23–48). London: Oxford University Press.Google Scholar
  19. Clute, K. F. (1963). The general practitioner. Toronto: University of Toronto Press.Google Scholar
  20. Cohen, F. (1985). Stress and bodily illness. In A. L. Monat & R. S. Lazarus (Eds.), Stress and coping: An anthology (pp. 40–54). New York: Columbia University Press.Google Scholar
  21. Cousins, N. (1983). The healing heart. New York: Norton.Google Scholar
  22. DiMatteo, M. R., & Friedman, H. S. (1980). Social psychology and medicine. Cambridge, MA: Oel-geschlager, Gunn & Hain.Google Scholar
  23. Egberg, S., Battit, G. E., Welch, C. E., & Battlet, M. K. (1964). Reduction of postoperative pain by encouragement and instruction of patients. New England Journal of Medicine, 270, 825–827.CrossRefGoogle Scholar
  24. Eisenberg, L., & Kleinman, A. (1981). Clinical social science. In L. Eisenberg & A. Kleinman (Eds.), The relevance of social science for medicine (pp. 7–20). Dordrecht: Reidel.CrossRefGoogle Scholar
  25. Engel, G. L. (1977). The need for a new medical model: A challenge for bio-medicine. Science, 196, 129–136.PubMedCrossRefGoogle Scholar
  26. Fitts, W. T., & Fitts, B. (1955). Ethical standards of the medical profession. Annals of the American Academy of Political and Social Science, 297, 25.CrossRefGoogle Scholar
  27. Guttman, L., & Levy, S. (1975). Structure and dynamics of worries. Sociometry, 38, 448–473.Google Scholar
  28. Hadley, C. G., & Crispen, J. E. (1978). Unprofessional physicians—Some correlative data. Western Journal of Medicine, 128, 85–88.PubMedGoogle Scholar
  29. Hall, J. A., Roter, D. L., & Rand, C. S. (1981). Communication of affect between patient and physician. Journal of Health and Social Behavior, 22, 18–30.PubMedCrossRefGoogle Scholar
  30. Hall, O. (1964). The informal organization of medical practice. Canadian Journal of Economics and Political Science, 12, 30–44.CrossRefGoogle Scholar
  31. Haug, M. R. (1976). The erosion of professional authority: A cross-cultural inquiry in the case of the physician. Milbank Memorial Fund Quarterly, 54, 83–105.CrossRefGoogle Scholar
  32. Haug, M. R., & Lavin, B. (1981). Practitioner or patient—Who’s in charge? Journal of Health and Social Behavior, 22, 212–229.PubMedCrossRefGoogle Scholar
  33. Hayes-Bautista, D. E. (1976). Modifying the treatment: Patient compliance, patient control and medical care. Social Science and Medicine, 10, 233–238.PubMedCrossRefGoogle Scholar
  34. Hellerstein, H. H., & Ford, A. B. (1960). Comprehensive care of the coronary patient: Optimal (intensive) care recovery and reconditioning: An opportunity for the physician. Circulation, 22, 1166.PubMedCrossRefGoogle Scholar
  35. Henao, S. (1985). A system’s approach to family medicine. In S. Henao (Ed.), Principles of family medicine (pp. 24–40). New York: Brunner/Mazel.Google Scholar
  36. Hornung, C. A., & Massagli, M. (1979). Primary care physicians’ affective orientation toward patients. Journal of Health and Social Behavior, 20, 61–76.PubMedCrossRefGoogle Scholar
  37. Illich, I. (1976). Medical nemesis. New York: Pantheon.Google Scholar
  38. Jensen, M. M. (1981). Emotional stress and susceptibility to infectious diseases. In K. Bammer & H. Newberry (Eds.), Stress and cancer (pp. 59–70). Toronto: Hogrefe.Google Scholar
  39. Kasteler, J., Kane, R. L., Olson, D. M., & Thetford, C. (1976). Issues underlying prevalence of doctor-shopping behavior. Journal of Health and Social Behavior, 17, 328–339.CrossRefGoogle Scholar
  40. Korman, M., Pate, M. L., & Chapman, T. S. (1980). Selection of primary care as medical career: Demographic and psychological correlates. Southern Medical Journal, 73, 924–927.PubMedCrossRefGoogle Scholar
  41. Kosa, J., & Robertson, L. S. (1969). The social aspects of health and illness. In J. Kosa, A. Anto-novsky, & I. K. Zola (Eds.), Poverty and health: A sociological analysis (pp. 35–68). Cambridge, MA: Harvard University Press.Google Scholar
  42. Leigh, H., & Reiser, F. (1980). The patient. New York: Plenum Press.CrossRefGoogle Scholar
  43. Ley, P., & Spelman, M. S. (1967). Communicating with the patient. London: Staples.Google Scholar
  44. Lown, B. (1983). Introduction. In N. Cousins, The healing heart (pp. 11–28). New York: Norton.Google Scholar
  45. Mauksch, M. O. (1974). A social science basis for conceptualizing family health. Social Science and Medicine, 8, 487–493.CrossRefGoogle Scholar
  46. McPhee, J. M. (1984, July). Heirs of general practice. The New Yorker, pp. 40-85.Google Scholar
  47. Mechanic, D. (1976). The growth of bureaucratized medicine. New York: Wiley.Google Scholar
  48. Miller, A. E. (1972). The expanding definition of disease and health in community medicine. Social Science and Medicine, 6, 573–581.PubMedCrossRefGoogle Scholar
  49. Norbeck, J. S., & Peterson-Tilden, V. (1983). Life-stress, social support, and emotional disequilibrium in complications of pregnancy: A prospective multivariate study. Journal of Health and Social Behavior, 24, 30–46.PubMedCrossRefGoogle Scholar
  50. Pattison, E. M., & Anderson, R. C. (1978). Family health care. Public Health Reviews, 7, 83–134.PubMedGoogle Scholar
  51. Ransom, D. C. (1985). The evolution from an individual to a family approach. In S. Henao & N. P. Grose (Eds.), Principles of family systems in family medicine (pp. 5–23). New York: Brunner/ Mazel.Google Scholar
  52. Rave, A. (1978). Finding periodic patterns in time series with monotonic trend: A new technique. In S. Shye (Ed.), Theory construction and data analysis in the behavioral sciences (pp. 371–390). San Francisco: Jussey-Bass.Google Scholar
  53. Ross, C., Wheaton, B., & Duff, R. S. (1981). Client satisfaction and the organization of medical practice. Journal of Health and Social Behavior, 22, 243–255.PubMedCrossRefGoogle Scholar
  54. Schlesinger, E. G. (1985). Health care and social work practice. St. Louis: Times Mirror/Mosby.Google Scholar
  55. Sehnert, K. W., & Eisenberg, H. (1975). How to be your own doctor. New York: Grosset & Dunlap.Google Scholar
  56. Sklar, S., & Anisman, H. (1981). Contributions of stress and coping to cancer development and growth. In K. Bammer & H. Newberry (Eds.), Stress and cancer (pp. 98–136). Toronto: Hogrefe.Google Scholar
  57. Stimson, G., & Webb, B. (1975). Going to see the doctor. London: Routledge & Kegan Paul.Google Scholar
  58. Tessler, R., Mechanic, D., & Dimond, M. (1976). The effect of psychological distress on physician utilization. Journal of Health and Social Behavior, 17, 353–369.PubMedCrossRefGoogle Scholar
  59. Tuckett, D. (1976). Doctors and patients. In B. Tuckett (Ed.), Medical sociology (pp. 190–224). London: Tavistock.Google Scholar
  60. Vickery, D. M., & Fries, J. F. (1976). Take care of yourself. Reading, MA: Addison-Wesley.Google Scholar
  61. Wallis, C. (1986, May 26). Weeding out the incompetent. Time, pp. 57-58.Google Scholar
  62. Wan, T. T., & Soifer, S. V. (1974). Determinants of physician utilization: A causal analysis. Journal of Health and Social Behavior, 15, 100–108.PubMedCrossRefGoogle Scholar
  63. Weitzkin, H., & Stoeckle, J. D. (1976). Information control and the micropolitics of health care. Social Science and Medicine, 10, 263–276.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Zeev Ben-Sira
    • 1
  1. 1.School of Social WorkThe Hebrew University of JerusalemMount Scopus, JerusalemIsrael

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