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Resumo

The clinical negotiation model proposed by Katon and Kleinman (1981) puts culture at the very heart of the patient‐doctor relationship. As opposed to the asymmetric model that stresses an unequal power relationship between a dominant physician and a powerless patient, this transactional model suggests that we view the clinical encounter as the locus of a negotiation that takes place between two kinds of knowledge (lay and professional), and between two agendas: the doctor's and the patient's. According to such a model, the doctor is taught to listen to the patient's own explanatory model of disease. Using an in‐depth analysis of clinical encounters between perimenopausal women and female physicians, and of separate interviews with individual doctors and patients concerning their respective explanatory models, this pilot study puts emphasis on both the limitations of a transactional model and on the strategies deployed by doctors for enhancing the credibility of hormonal replacement therapy.

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