1.05 - The Doctor-Patient Relationship Flashcards
What are the four elements of the doctor-patient relationship?
Parentalist Model
Partnership Model
Consumerist Model
Interpretive Model
Describe the Parentalist model and in what situation(s) it is used.
Involve doctors providing guidance. Assume that you and the patient’s share a common objective and your patient is seeking, or needs, guidance.
Used in situations where patients are very unwell.
Describe the Partnership model and in what situation(s) it is used.
It is patient centred and is the dominant model taught in medical training.
Assumes ideal state is a horizontal power relationship between patients and doctors.
Rests on mutual respect.
Tends to be very useful in long-term conditions
Describe the Consumerist model and in what situation(s) it is used.
Rights driven.
Patients have the right to complete autonomy and the role of the doctor is to undertake to provide information.
Cultural equation of information with power
Tend to be very useful with conditions where the patient can act as an informed consumer (generally discretionary health issues, e.g. cosmetic surgery)
Describe the Interpretive model and in what situation(s) it is used.
Doctors work with patients to explore issues underpinning behaviours and illnesses (patient may not be aware of these).
Rests on the principle that self-understanding is critical to good care.
Useful for complex, often chronic, illnesses and complex social situations. Requires time.
What are some Pro’s and Con’s of the Parentalist model
Pro’s: Acknowledges medical asymmetry. Useful when patient is seriously ill and unable to be “senior partner” in their health care.
Con’s: Can lead to ethical and professional ‘bear traps’. Doctors aren’t parents
What are some Pro’s and Con’s of the Partnership model
Pro’s: Mutually respectful. Acknowledges patient autonomy
Con’s: Can and may be culturally inappropriate. Assumption of horizontal power relationship is asocial
What are some Pro’s and Con’s of the Consumerist model
Pro’s: Acknowledges patient autonomy. Underlies role of doctor as educator.
Con’s: Can allow doctor to disengage. “Blame the patient”
Assumes that choice is liberating. Ignores power hierarchies in the consultation
What are some Pro’s and Con’s of the Interpretive model
Pro’s: They support good diagnosis and therapy planning. Take into account the many determinants of illness
They are very rewarding
There’s not always time to do this.
Third party work can be difficult
What does and does not determine the appropriate doctor-patient relationship model?
It is best determined by context and not by your own personal preference or the patients demographic.
