Interaction process in medical consultations: Different approaches to male impotence

A healthcare setting is a place in which people interact, and this interaction is influenced by the cultural background of the healthcare professionals, which in turn plays a crucial role in the way in which the disease is treated. Currently, the approach to sexual dysfunction, and in particular male impotence, is becoming more medicalized, due to the onset of new pharmacological treatments, to the detriment of the psychological and social dimensions of the disorder, which are increasingly neglected. Since the patient's construction of the disease is in large part influenced by the doctor's actions, we focused on an analysis of the consultation, comparing two different medical specialties. The study data consists of observations of urological and psychiatric consultations involving men consulting at the hospital for impotence. We analyzed the differences in approach between the type of practitioner, the interpersonal scripts that were played out during the consultations, and the communication and practical aspects of treatments provided during these medical consultations. Rather than simply describing the various types of clinical practice, the importance of promoting methods of interaction that facilitate patient/doctor co-operation during sexology consultations is emphasized. (C) 2009 Elsevier Masson SAS. All rights reserved.