PHYSICIAN PATIENT

RELATIONSHIP
NURUL FARAH WAHIDAH ABD RAZAK
118129
GROUP 2

INTRODUCTION

DEFINITION:
The interaction between
the physician and the
patient to return to
health, alleviate suffering
and prevent illness

The core of practice of medicine

Aka patient-physician the order sometimes reversed to
reinforced that the treatment should always be patientcentered.
Relationship vary depending on each of their personalities,
past experiences, setting and purpose of the encounter.
However, there are general principles that, when followed
help ensure that the relationship established is helpful.

WHY DOES IT MATTER?

DP relationship is fundamental
for providing:
i. Excellent care
ii. Healing process
iii.Improve outcomes

Therefore, it is important to
understand what elements
comprise the relationship
and identify those that
make it good

DOCTOR-PATIENT RELATIONSHIP

PATIENT

Is a human seeking for

help to improve their
health or prevent
disease
Always carries a degree
of fear and anxiety

SkilledDOCTOR
professional
with:
Leadership
Emotional
intelligence
Strong
communication skills

PARSONS MODEL (1951)

Parsons ideal patient (sick

role)
Rights (permitted) to:
Give up some activities and
responsibilities
Regarded as being in need for care

Obligations (in return):

Must want to get better quickly
Seek help and cooperate with a doctor

Parsons ideal doctor

(doctors role)
Apply a high degree of skill &
knowledge to the problems of illness
Act for welfare of patient and
community rather than self interest,
desire for money, advancement
Be objective and emotionally detached
Be guided by rules of professional
practice

TYPES OF DOCTOR PATIENT

RELATIONSHIP
TYPES

PHYSICIAN
CONTROL (LOW)

PHYSICIAN
CONTROL (HIGH)

PATIENT CONTROL
(LOW)

DEFAULT

PATERNALISM

PATIENT CONTROL
(HIGH)

CONSUMERISM

MUTUALITY

PATERNALISM

Is widely regarded as the traditional form

of D-P relationship
Passive/submissive patient
Dominant doctor
It is assumed that the doctor knows best
Patient is expected to comply without
questioning
Desirable in some situations

ADVANTAGES

DISADVANTAGES

Important when the

patient is very sick
Relief from burden of
worry is curative in
itself
Trust and confidence
implied by this model
allow doctor to perform
medical magic
placebo effect

Manipulation &
exploitation of the
vulnerable and ill

MUTUALITY
The optimal D-P relationship model
Each of participants brings strengths and resources
to the relationship
Based on communications between dr and patients
PATIENTS ROLE
Define their problem in an open
& full manner
Right to seek care elsewhere
when demands are not
satisfactory met

DOCTORS ROLE
Need to work with patient to
articulate the problem & refine
the request
Right to withdraw services
formally from a patient if he/she
feels it is impossible to satisfy
the patient

ADVANTAGES

Patient can fully

understand what
problem they are
coping with
Doctor can entirely
know patients value
Decisions can be easily
made from a mutual
and collaborative
relationship

DISADVANTAGES

If communication
fake, both dr &
patient do not have
mutual
understanding,
making the decision
is overwhelming to a
patient.

CONSUMERISM
Reverse of the very basic nature of the power
relationship
Pt taking active role and dr adopting a fairly
passive role

PATIENTS ROLE
HEALTH SHOPPER

INDICATIONS OF CONSUMER
BEHAVIOR:
Cost consciousness
Information seeking
Exercise independent judgment

DRS ROLE
Health care provider
Technical consultant
To convince the necessity of
medical services

ADVANTAGES

Patient can have their

own choices

DISADVANTAGES

When tings seem to

go wrong, when
satisfaction is low,
when patient suspect
less than optimal care
or outcome:
Patients are more likely
to question physician
authority

DEFAULT

When patient &physician are at odd

Patient adopt passive role & dr reduce his
control
When the need for change in the relationship
can not be negotiated
the relationship may come to a dysfunction
standstill