1.6 - The Doctor-Patient Relationship Flashcards
What are fantasy-based elements?
Transference- derived from patient’s pattern of learned interpersonal behavior
What are the elements of a doctor-patient relationship?
- Reality-based elements
2. Fantasy-based elements
What is fundamental to a doctor-patient relationship?
Trust
- interactive process
- need care, concern, compassion
- listening as central focus
- built thru repeated interactions and met expectations
What are the characteristics of the doctor?
Medical knowledge Understanding patient's context (situation and value system) Self-awareness Communication skills Interview techniques
What are the characteristics of the patient?
Gender
Age
Individual history
Unique personality (genetic makeup, life experiences)
Member of a group (ex. Family, work, etc)
Belonging to a community
What is the function of a clinical interview?
Sets the stage for identifying relevant problems in context of empathic working alliance with a patient
What is rapport?
Spontaneous, conscious feeling of harmonious responsiveness that promotes therapeutic relationship
-implies understanding and trust bet. doctor and patient
What is transference?
Process of displacing attitudes and feelings originally experience in relationships with persons from the past
-can be positive or negative
Process by which doctors unconsciously ascribe motives or attributes to patients that comes from doctor’s past
Countertransference
What are the models of doctor-patient relationship?
Paternalistic
Informative
Interpretive
Deliberative
What is the paternalistic model?
“Doctor knows best”
Patient must comply without questioning
What is the paternalistic model appropriate?
When doctors need to take control
-emergency
What is the disadvantage of the paternalistic model?
Risk clash of values
What is the informative model?
Doctor dispenses information
All available data are freely given but choice is left to patient
When is the informative model appropriate?
Appropriate for one-time consulatitions (exec check ups)
What is the interpretive model?
Doctor presents and discusses alternatives with patient’s participation
Shared decision making
When is the interpretive model appropriate?
Appropriate for those with chronic disease requiring follow up (e.g. Diabetes)
What is the multidisciplinary approach?
Philosophy and process of care that integrates the specialized knowledge of multiple disciplines
What is the deliberative model?
Docotr acts as a friend and counselor
Doctor presents info and actively advocates a particular course of action
When is the deliberative model appropriate?
Appropriate in modifying behavior (e.g smoking cessation)
Who are the members of the health care team?
Physicians Nurses Rehab experts, therapists Social workers Counselors
A patient who has rapid speech, thinks aloud, interrupts, has loud voice is _______.
Extroversion
Extroverted
A patient who asks for step by step info, asks about present situation, asks what or how questions, uses precise descriptions is _____.
Sensing
A patient who tests your knowledge, weigh objective evidence, not impressed by other’s decisions, and their conversations follow logical patterns, “if this, then that” is ________.
Thinking
A patient who is impatient with long descriptions or procedures, whose tone is in a hurry, makes decisions prematurely, enjoys getting things done is _____.
Judging
How do you resolve countertransference?
bracketing
A patient who pauses, think things through, is quiet, and uses shorter sentences is ____.
Introverted
Introversion
A patient who asks for purpose of the action, asks for current and long term implications, asks why questions, talks in general terms and possibilities
Intuitive
Intuition
A patient who strives for harmony, talks about value, asks how others acted or resolved similar situation, matters whether others have been taken into account is ______.
Feeling
A patient who wants space to make a decision, explores, decides at last moment, enjoys processing is _____.
Perceiving
