Thursday, 10 November 2011

Doctor Patient Relationship

Two simple models on doctor patient relationship.One is doctor as an expert adviser and  the other is doctor in partnership.

Doctor as an expert adviser  
  • Docotor defines the patient's needs
  • Doctor advises the patient what to do
  • Doctor solves problems for the patient
  • Doctor decide how much information to be given to the patient

Doctor  in  partnership
  • Doctor elicit the patient's problems & needs
  • Doctor explains the options to the patient
  • Doctor and the patient explore the solutions to gether
  • Doctor ask what information the patient wants
What is your style ?

 Emanuel and Emanuel ( JAMA. 1992 Apr 22-29;267(16):2221-6.) elaborated four models of doctor patient relationships:
  1. Paternalistic: physician makes decisions for the patient’s benefit independent of the patients values or desires
  2. Informative: physician provides information, patient applies values and decides.
  3. Interpretive: patient is uncertain about values, physician, as counselor, assists the patient in elucidating his or her values.
  4. Deliberative: Patient is open to development, physician teaches desirable values
Interestingly another article,Physician-Patient Relations: No More Models, argues that one model doesn't fit all.Based on my experience,I agree with this article.What do you think?