Doctor-Patient Interaction Chapter 9 Chapter 9 Flashcards
Doctor-Patient Relations
•critical for delivering quality care
•asymmetric balance of power, and knowlwdge
•emotional association
•difference in how health problems is defined
-patient concern=they think its a disruption of function and life
-doctor concern= doctor is to diagnose and treat the condition
Szasz and Hollender:
interaction depends on severity of symptoms
1.)Activity–Passivity Model:
• Patient is seriously ill or being treated on an emergency basis in a state of relative helplessness
(doctor has full responsibility of treatment)
Szasz and Hollender:
interaction depends on severity of symptoms
2.)Guidance–Cooperation Model:
•Patient has an acute, often infectious illness
• Patient knows what is going on, and can cooperate with the physician, but the physician makes the decisions
Szasz and Hollender:
interaction depends on severity of symptoms
3.)Mutual Participation Model:
•Management of chronic illness
• Patient works with the doctor as a full participant in
controlling the affliction
• Both share responsibility and power
• Good communication is crucial for patient outcome
Introduction
• Parsons’ concept of the sick role explains the obligations of the patients and the physicians toward each other
– the patients should cooperate with doctors, and doctors should attempt to return patients to normal level of functioning as possible
• Medical decision rule
– Is the guiding principle behind everyday medical practice
– Since the work of the physician is for the good of the
patient, physicians tend to impute(assign) illness to their patients rather than to deny it and risk overlooking or missing it
Misunderstandings in Communication
• Information can be an important tool in medical situations if it meets three
tests:
1) Reduces uncertainty
2) Provides a basis for action
3) Strengthens the physician–patient relationship
• There are still instances of misunderstanding
in communication or times when a doctor
withholds information
Communication and Class Background
• Doctors from upper-middle-class backgrounds tended
to communicate more information to their patients
than doctors with lower-middle- or working-class
backgrounds.
• Patients from a higher class position or educational level get more information
• The greater the dissimilarity between patient and
doctor in social class, the increased likelihood for
miscommunication
– Patients and doctors sharing a similar class also share similar communication styles
Medication Adherence/Complience
• the critical outcome of communication is Adherence to treatment and medication
Adherence
is the extent to which the patient take medication as prescribed
Rate of non-Adherence
50% of patients DO NOT take prescribe meds
30% of prescription are not even filled
Consequences of Non-Adherence
33-66% of hospital admissions are due to non-Adherence
total cost=100 billion a year
cost of Non-Adherence are complex:
cost
side-effects, real or preceived
lack of effects, real or preceived
duration and complexity of medication
physical difficulities: swallowing, opening lids
doctor interaction factors: failure to communicate
Low Health Literacy
90 million of U.S. adults lack reading and math skills, to navigate the health care system
standard medical information is written above the average reading level of U.S. adults
