Doctor Patient Relashionships P1 Flashcards

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1
Q
  1. What are the three types of practices in medicine that are associated with doctor-patient relationships?
A
  1. The progression from bedside medicine to laboratory
    medicine
  2. Patient-Centred Medicine
  3. Evidence-Based Medicine
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2
Q
  1. When did the progression from bedside to laboratory medicine happen?
A
  • during the early 19 century
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3
Q
  1. What was the focus of bedside medicine?
A
  • if focused on the manifestation of the disease
  • it focused on the symptoms of the disease alone
  • it did not focus on the cause of the disease
  • it did not focus on its internal and hidden causes
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4
Q
  1. What can be said about the diagnosis and the treatment that happened with Bedside Medicine?
A
  • they were both rather subjective
  • they were based on the Doctor’s Understanding
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5
Q
  1. What caused the progression from bedside medicine to laboratory medicine?
A
  • more and more patients were being hospitalised
  • there became a centralised approach to medicine
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6
Q
  1. What were the effects of the progression from bedside medicine to laboratory medicine?
A
  • there became a general agreement about which diagnosis and therapy were to be used
  • there was en emphasis on pathology
  • an emphasis on the underlying causes and the internal
    causes
  • there was a shift to laboratory medicine
  • this was the beginning of evidence based medicine
  • it brought about a importance of laboratory tests
  • these would be used to see how the disease should be
    managed
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7
Q
  1. In the past clinical experience guided treatment, what happened if a drug worked in clinical practice?
A
  • it would be used again
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8
Q
  1. What kind of medical shift has occurred in recent times with regards to Evidence-based medicine?
A
  • a shift towards establishing an objective effectiveness of practice and treatment
  • evidence is now coming from research and trails
  • evidence is no longer just coming from everyday practice
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9
Q
  1. What kind of turn happened in the 1980s in Medicine?
A
  • there has been a systematic turn to Patient Centred
    Medicine
  • this is the combination of biological, psychological and social perspectives
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10
Q
  1. How does Patient Centred Medicine work?
A
  • patients provide information to their doctors
  • the doctors decide on a diagnosis
  • patients are actively engaged in the management of
    the their own condition
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11
Q
  1. For which kind of diseases is a Patient-Centred approach most appropriate for?
A
  • Chronic diseases
  • these involve the long term collaboration between doctors and patients
  • there is much patient-doctor communication
  • there is much patient involvement
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12
Q
  1. Within Society, do patients and doctors have roles to fulfil?
A
  • yes
  • the doctors have to provide the best treatment they
    possibly can using their knowledge
  • they have to provide fair treatment
  • the patients have to adopt the sick role
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13
Q
  1. What are the obligations of a patient who has adopted the Sick Role (according to Parson’s Model)?
A
  • the patient must want to get well as quickly as possible
  • they should seek medical help
  • they are excused and understood by society for their actions
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14
Q
  1. What are the rights of a patient who has adopted the Sick Role (according to Parson’s Model)?
A
  • the patient is allowed to withdraw from daily activities
  • they are regarded as unable to get better by their own
    decision and will
  • they have autonomy over themselves throughout this
    whole process
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15
Q
  1. What are the obligations of the doctor within the Sick Role (according to Parson’s Model)?
A
  • they must apply a high degree of skills and knowledge
  • they must act for the good of the patients
  • they must act for the good of the community
  • they must be objective
  • they must be emotionally detached
  • they are guided by the rules of the professional
    practice
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16
Q
  1. What are the rights of the doctor within the Sick Role (according to Parson’s Model)?
A
  • they are granted rights to examine the patients physically
  • they are granted the autonomy in medical practice
  • they have a position of authority in relation to the patient
17
Q
  1. What did Talcott Parsons use the roles of the doctors and the patients to show?
A
  • stability can be achieved in health care organisations
  • the hospital is viewed as a MicroSociety
  • harmony can be obtained within this MicroSociety if
    the doctors and the patients both act according to their
    roles
18
Q
  1. What does stability in the Health Care organisations result in?
A
  • functionality
  • it allows patients to return to social activities
  • the whole society is therefore stable
  • this makes the whole society functional
19
Q
  1. What is observed despite the roles of patients and doctors?
A
  • CONFLICT
20
Q
  1. Why can conflict arise between patients and doctors?
A
  1. The doctors and the patients have different values
    - they struggle to find common ground
  2. Confidentiality
    - doctors may breach this outside any guidelines
    - this can happen before the patient is informed
  3. Doctors may not be able to determine the cause of
    the patient’s symptoms
    • this may frustrate the patient
  4. Doctors may not be able to coordinate:
    • an effectively objective treatment
    • a patient-centred approach
    • a cost-effective treatment for the health care system
  5. The patient may not respect the doctor’s decisions
21
Q
  1. What are the four types of power and control relationships that influence doctor-patient relationships?
A
  1. Paternalistic Relationship
    • high doctor control
    • low patient control
    • this is more a practice of the past
  2. Mutuality
    - equal control
  3. Consumerist
    • low doctor control
    • high patient control
    • this might be found in private consultations
  4. Default
    • low doctor control
    • low patient control
    • this is the most problematic type
    • there is no one leading the process
    • the doctor and the patient cannot agree with one
      another
    • there is a lack of care on both sides
22
Q
  1. What are the most common types of Doctor-Patient relationships?
A
  • Paternalistic Relationship
  • Mutuality
23
Q
  1. What influences Doctor-Patient relationships?
A
  • the doctor’s perception of their own role
  • the doctor’s perception of the patient’s role
  • patient expectations when playing their sick role
  • younger and highly educated patients expect a more
    patient-centred consultation
24
Q
  1. Which two factors is medical practice guided by?
A
  • professional directives
  • professional guidelines
25
Q
  1. Read through this summary.
    Does everything make sense?
A
  • yes