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Background: Communication and social interaction during the hospital ward round significantly influence the distribution of power between health personnel and the service user or patient. We need knowledge about the ways in which the social roles of doctor and patient influence patient empowerment. Patient engagement with the healing process is not only an entitlement; it is potentially significant for the outcome of hospital treatments. Objective: The article focuses on how established social and cultural practices affect the roles of doctor and patient during hospital ward rounds. The objective is to point to the limitations and opportunities that exist in order to facilitate more empowering communication during the hospital ward round. Method: The article is based on our qualitative field study that involved participatory observations of ward rounds. We have analysed the gathered data using an incremental deductive-inductive method. Results: The results show that the role-specific behaviours of doctors and patients during ward rounds can contribute to disempowerment. The doctor’s role may not necessarily reflect an overtly paternalistic attitude, but it is nevertheless based on a view that doctors are ‘exclusive experts’ and patients should be their subordinates. Patients therefore tend to underestimate their own knowledge about their health and generally take on the traditional role of being ‘passive and dependent’. Conclusion: Assuming that the disempowerment is largely inflicted by internalised role behaviours in patients as well as doctors, we discuss the need for awareness-raising and specific measures capable of challenging these role conceptualisation. In particular, we point to ways of conducting the ward round that expressly challenge the doctor’s role as an ‘exclusive expert’, and the patient’s role of being ‘passive and dependent’.

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