doctor-patients relationships

Question 1

3 types of practicing medicine that associate with doctor-patients relationships

Answer 1

• from bedside to laboratory medicine
• patient-centered medicine
• evidence-based medicine

Question 2

bedside to laboratory medicine

Answer 2

focused on manifestation of disease - not its internal and hidden causes

• emphasis on pathology and underlying causes

Question 3

patient-centered medicine

Answer 3

• medicine shifted towards establishing an objective effectiveness of practice
• combine biological, psychological, and social perspective of patients

Question 4

parson’s model of the sick role:

Answer 4

obligations/expectations
- patients must want to get well as quickly as possible

• they should seek medical help

rights:
- allowed to withdraw from activities
- regarded as unable to get better by

Question 5

parson’s model of the doctor’s role

Answer 5

obligations/expectations
- apply high degree of skill and knowledge
- act for the good of patients and community
- be objective and emotionally detached

rights
- granted rights to examine patients physically
- granted autonomy
- has a position of authority

Question 6

how can stability cause heath care organizations to be functional?

Answer 6

when patients return to social activities then the whole society is stable, and thus functional

Question 7

what conflicts may be observed, in spite of these two roles

Answer 7

• different values between patients and doctors
• confidentiality
• doctors may not be able to determine the cause of patient’s symptoms
• ineffective communication
• doctors may not be able to coordinate an effectively objective treatment, patient-centered approach, cost-effective treatment

Question 8

4 types of doctor-patient relationships

Answer 8

1. paternalistic relationship
2. mutuality
3. consumerist
4. default

Question 9

paternalistic relationship

Answer 9

high doctor control, low patient control

Question 10

mutuality

Answer 10

equal control

Question 11

consumerist

Answer 11

low doctor control, high patient control

(might be found in private consultations)

Question 12

default

Answer 12

low doctor control, low patient control

Question 13

most common types of doctor-patient relationships

Answer 13

paternalistic and mutuality

Question 14

younger and highly educated patients expect a more

Answer 14

patient-centered consultation

Question 15

how did medical consultations change over time?

Answer 15

traditionally doctors wanted to understand the symptoms and the patient’s experiences, which recently changed to making patients more involved

Question 16

3 main models of treatment decision-making

Answer 16

• professional choice (doctor decides)
• shared choice (to achieve concordance)
• consumer choice (patient decides)

Question 17

why might patients not prefer to have a shared choice?

Answer 17

when patients are in crisis, they prefer the decision to be made for them

Question 18

basic communication skills for history taking

Answer 18

1. initiate the consultations
2. consent and confidentiality
3. use of closed and open questions
4. check patients’ perspective
5. empathize
6. signpost
7. check patient’s understanding
8. summarize
   9 . close the consultation

Question 19

initiate the consultations

Answer 19

• introduce yourself
• explain the purpose of the consultation

Question 20

consent and confidentiality

Answer 20

• obtain consent
• ensure confidentiality

Question 21

use of closed and open questions

Answer 21

closed questions - question that lead to given answers

open questions - which allow patient to narrate

Question 22

check patient’s perspective

Answer 22

check what the patient think by using an open question

Question 23

empathize (RAV)

Answer 23

recognize - pick up the cues

accept - non-judgemental
acknowledge - confirm that emotion is there

validate - confirm that the emotion is valid

Question 24

signpost

Answer 24

prepare the patient of the area you are exploring next

Question 25

check patient’s understanding

Answer 25

you can ask the patient how they understand medical terms, conditions, if everything is clear, to summarize what you have told them

Question 26

summarize and close the consultation

Answer 26

• summarize so to make sure that you have understood well
• inform the patient what you plan to do with that information