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are guilty of a positivistic bias, leaving the absolutist claim of service providersand their predominantly pragmatic motives largely unquestioned.Consequently be proposes that some of the shortcomings of the traditionalapproaches might be overcome by microsociological studies as an alternativemethodology.Recently other sociologists have also questioned the passivity model of thepatient. These studies, which are essentially microsociological, include thestudies of patient impetus (Davis, Horobin (eds.) 1977). In addition,contemporary observational studies characterise medical encounters asnegotiated occasions in which all parties strive to achieve their separate endsvia a variety of strategies (Balint 1957; Roth 1963; Katz et. al. 1969; Stimson,Webb 1975).Microsociological studies are represented by various phenomenologicalschools, most notably interactionism and ethnomethodology. As such they arecharacterised by attention to meaning and interpretation and by denial of thesocial structure in the macrosociological sense. These studies customarilyprovide for a dialectical construction of social reality. Hence,microsociological studies require a qualitative approach which provides for anunderstanding of the actor’s definition of the social situation and the meaningswhich he finds in it.Free download from www.hsrcpress.ac.za2.2 Statement of the problemA microsociological approach within the field of medical sociology seemedparticularly well-suited for a study of elderly persons seeking health care at anoutpatient centre who are likely to be medically indigent and suffering fromchronic diseases typical of aging (Shanas 1962: 34). In particular this approachwould enable an understanding of the effects of medical treatment and thepatient role on the individuals’ perception of self.Problems that elderly persons who attend outpatient centres purportedlyexperience are difficulties with transportation to and from the centre; longwaits to clerk in, see the doctor and collect prescriptions; impersonalconsultations with different doctors on each occasion, and abruptness andimpatience from hospital staff. The experience and perception of thesedifficulties by elderly patients may create psychosocial problems for them inthe form of feelings of depersonalisation. This has implications for the selfdefinitionsof these persons, in their perception of their capacity to cope withthe exigencies of seeking medical treatment at a centre and simultaneouslyretain favourable self- images.The situation of elderly persons seeking health care at an outpatient centre wastherefore seen to constitute a sociological problem inasmuch as elements ofdepersonalisation might inhere in the service and care. The primary hypothesisof the study was that elderly persons who seek medical care at a201