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Abstract

In clinical settings, physician-patient disagreements are commonplace. These disagreements not only harm patient care but also pose challenges to physicians. Existing literature has illustrated the distress experienced by senior doctors and their efforts to handle patient conflicts. However, as junior doctors play multiple roles, including that of students and practitioners, their experiences in such conflicts differ from those of their senior counterparts and are under-researched. This study aims to explore junior doctors’ experiences of physician-patient disagreements to understand their roles and actions in handling such conflicts, as well as the challenges and suffering they encounter in these situations. I conducted in-depth, semi-structured interviews with 13 post-graduate-year (PGY) doctors in Taiwan to understand more about their experiences and challenges in managing physician-patient disagreements. According to the interviews, this study reveals three main findings. First, PGY doctors not only oversee frontline patient care but also act as mediators between the attending physicians and the patients during disputes. Second, despite the constraints of the medical hierarchy, PGY doctors possess the agency to manage conflicts based on their medical judgment. Third, in managing physician-patient disagreements, PGY doctors endure three major sources of pressure: from themselves, the attending physicians, and the patients. This research highlights the critical sociological roles that PGY doctors play as mediators in physician-patient disagreements. It examines how they facilitate communication, de-escalate conflicts, and advocate for resolutions that align with their medical judgment. A crucial aspect of their mediation work involves bidirectional emotional labor toward both the attending physicians and the patients, which they are compelled to do due to the medical hierarchy. Finally, I propose some clinical implications derived from this study to address junior doctors’ distress in physician-patient disagreements and help create a more supportive working and learning environment for them.

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