Professional dominance? Encounters between physicians and patients in the first half of the 19th century under the Habsburg Monarchy

In Vienna, the tradition of clinical teaching began with Anton de Haen’s introduction of the newly established educational approach in the Buergerspital in 1754. In the second half of the 18th century, clinical teaching at medical faculties contributed to the shift of power relationships between doctors and patients. The medical gaze that the doctor and the patient directed towards each other regulated the patients’ as well as the physicians’ behavior in the setting of hospital medicine, but this does not mean that a wholesale transformation of the medical field took place. Patients were not mere passive objects of externally controlled processes but influential agents of medical process. Middle- and upper-class patients sought assistance from their family general practitioners even at the beginning of the 20th century, and the relationships between these family doctors and their patients were more equal. Up to the end of the 19th century, physician-patient contact often comprised traditional methods of consultation by letter, and physicians saw and treated their patients predominantly in the patient’s homes. A doctor’s medical authority was not solely based on his knowledge, skills, and reputation among colleagues at the medical faculty. As in the early modern tradition of doctor-patient encounters, patients continued to play the role of ultimate arbiter of the performativity of physicians.