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?

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