1.6 - The Doctor-Patient Relationship

Question 0

What are fantasy-based elements?

Answer 0

Transference- derived from patient’s pattern of learned interpersonal behavior

Question 1

What are the elements of a doctor-patient relationship?

Answer 1

1. Reality-based elements

2. Fantasy-based elements

Question 2

What is fundamental to a doctor-patient relationship?

Answer 2

Trust

• interactive process
• need care, concern, compassion
• listening as central focus
• built thru repeated interactions and met expectations

Question 3

What are the characteristics of the doctor?

Answer 3

Medical knowledge
Understanding patient's context (situation and value system)
Self-awareness
Communication skills
Interview techniques

Question 4

What are the characteristics of the patient?

Answer 4

Gender
Age
Individual history
Unique personality (genetic makeup, life experiences)
Member of a group (ex. Family, work, etc)
Belonging to a community

Question 5

What is the function of a clinical interview?

Answer 5

Sets the stage for identifying relevant problems in context of empathic working alliance with a patient

Question 6

What is rapport?

Answer 6

Spontaneous, conscious feeling of harmonious responsiveness that promotes therapeutic relationship
-implies understanding and trust bet. doctor and patient

Question 7

What is transference?

Answer 7

Process of displacing attitudes and feelings originally experience in relationships with persons from the past
-can be positive or negative

Question 8

Process by which doctors unconsciously ascribe motives or attributes to patients that comes from doctor’s past

Answer 8

Countertransference

Question 9

What are the models of doctor-patient relationship?

Answer 9

Paternalistic
Informative
Interpretive
Deliberative

Question 10

What is the paternalistic model?

Answer 10

“Doctor knows best”

Patient must comply without questioning

Question 11

What is the paternalistic model appropriate?

Answer 11

When doctors need to take control

-emergency

Question 12

What is the disadvantage of the paternalistic model?

Answer 12

Risk clash of values

Question 13

What is the informative model?

Answer 13

Doctor dispenses information

All available data are freely given but choice is left to patient

Question 14

When is the informative model appropriate?

Answer 14

Appropriate for one-time consulatitions (exec check ups)

Question 15

What is the interpretive model?

Answer 15

Doctor presents and discusses alternatives with patient’s participation
Shared decision making

Question 16

When is the interpretive model appropriate?

Answer 16

Appropriate for those with chronic disease requiring follow up (e.g. Diabetes)

Question 17

What is the multidisciplinary approach?

Answer 17

Philosophy and process of care that integrates the specialized knowledge of multiple disciplines

Question 18

What is the deliberative model?

Answer 18

Docotr acts as a friend and counselor

Doctor presents info and actively advocates a particular course of action

Question 19

When is the deliberative model appropriate?

Answer 19

Appropriate in modifying behavior (e.g smoking cessation)

Question 20

Who are the members of the health care team?

Answer 20

Physicians
Nurses
Rehab experts, therapists
Social workers
Counselors

Question 21

A patient who has rapid speech, thinks aloud, interrupts, has loud voice is _______.

Answer 21

Extroversion

Extroverted

Question 22

A patient who asks for step by step info, asks about present situation, asks what or how questions, uses precise descriptions is _____.

Answer 22

Sensing

Question 23

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 ________.

Answer 23

Thinking

Question 24

A patient who is impatient with long descriptions or procedures, whose tone is in a hurry, makes decisions prematurely, enjoys getting things done is _____.

Answer 24

Judging

Question 25

How do you resolve countertransference?

Answer 25

bracketing

Question 26

A patient who pauses, think things through, is quiet, and uses shorter sentences is ____.

Answer 26

Introverted

Introversion

Question 27

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

Answer 27

Intuitive

Intuition

Question 28

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 ______.

Answer 28

Feeling

Question 29

A patient who wants space to make a decision, explores, decides at last moment, enjoys processing is _____.

Answer 29

Perceiving