Interaction between Doctor, Patient and Pharmaceutical Company in Perspective of Social Exchange at M. Yunus General Hospital Bengkulu

Abstract

This study done in answer to the question whether the interaction between doctor , patient and  pharmaceutical company in the process of therapy at M.Yunus General Hospital Bengkulu is social exchange ? A qualitative method and  the kind of research of case study design with explorative study obtained to answer this question.  Data was collected by observation , interview and documentation study. Data analysis  was conducted  with the qualitative analysis in interactive and sustainable process until the data had been completed and  saturated. The activities included trimming the data that was not relevant, data presentation and data conclusion.The study results showed that the actors involved in social exchange are the doctors , patients and medical representative ( medrep ). They are individual actor as part of an institutional community where they belong. Doctor and patient exchanged the material indirectly, and satisfied and dissatisfied feeling. While resources that was exchanged by doctors and medrep in the form of economically valuable and social gratuity given directly. Exchange structure develops in exchange relation for mutual benefit between doctors and medrep meanwhile patient relies on a physician in asymmetrical exchange relationships. In the beginning, the process of  exchange that occurs between doctor and patient was the natural relationship and then became asymmetrycal relationship that tend exploitative. Doctor as a healer did not pay attention on patients’s disease problems because distorted by other priorities when there is an offer from the pharmaceutical company. Initiation from the pharmaceutical company through medical representative, responded in reciprocal exchange so that the mutual benefit of both being transactional. The research also showed that the interaction that occurred between the doctor, patient and a pharmaceutical company was social exchange. The interaction between doctor and patient was paternalistic, non negotiated and showed the power imbalance relation. Doctors put in a superior position and patients constitute an individual under the subordination of doctor. Meanwhile, the interaction of doctors and medical representative occurring by reciprocal, negotiated and mutually profitable.

Keywords: interaction, doctor, patient, medical representative, power,  social exchange