A relational paradigm for the patient-doctor figuration, between engagement and shared doctoring

This paper aims to analyse the patient-doctor relationship as a form of citizen participation at a micro-level. The work presents the main findings of a study conducted in Italy in the field of type 1 diabetes in 2018, which recruited 47 patients and 20 doctors. Findings show that the patient-doctor relationship is properly explained with a relational perspective, as interdepend-ent figurations of transactors characterised by dynamic processes of power balances.

This approach helps to explain patients' participation by proposing the use of the relational concept of shared doctoring to buttress that of engagement. Indeed, the latter, despite its popularity, still seems to be erratic and blurred. In the end, the concept of engagement underpinned by shared doctoring could be useful for analysing patients' participation in the healthcare system at a microlevel by inverting healthcare's underlying foundations towards a logic of care, in place of the current leading logic of choice. [Publisher's text]