0314 - Patient Doctor relationship models - RM

Question 1

What are the key points of the parentalist model of care?

Answer 1

Health workers provide guidance, a very disproportionate power and knowledge relationship, as when patients are very unwell. Used in ED, ICU etc.Good for when a patient can’t be a senior partner in their care, and involves the doctor embodying parental care “thank God someone knowledgeable is in charge”. NOT paternalism.Can lead to ethical and professional problems - don’t want to override patient autonomy. Ultimately, doctor’s aren’t parents.

Question 2

What are the key points of the partnership model of care?

Answer 2

Patient-centred (partnership) medicine is dominant model through medical training. It assumed horizontal power between doctor and patient, resting on mutual respect. Is very valuable with long-term conditions, particularly with regards to patient autonomy.But can be culturally inappropriate, and the doctor/patient relationship isn’t really horizontal in power.Very good ‘base’ model.

Question 3

What are the key points of the consumerist model of care?

Answer 3

It’s rights-driven, with the patient taking the lead. They have autonomy, doctor provides information - assumes information is power. Assumes the patient has full control, the doctor just ‘ticks the boxes’.Very useful for discretionary health issues (cosmetic surgery, IVF etc).Can allow the doctor to disengage, but some people need help making their choices (choice is not always liberating). It also ignores the power hierarchies in the relationship.

Question 4

What are the key points of the interpretive model of care?

Answer 4

Doctors and patients work together to explore deeper issues. Allows the patient to have full understanding. Very time-consuming, but useful for complex illnesses or social situations.An excellent model of care if time allowed, but it doesn’t generally. Also inappropriate for third-party work where a doctor has to exercise their power after embarking on a journey together.