doctor-patients relationships Flashcards
3 types of practicing medicine that associate with doctor-patients relationships
- from bedside to laboratory medicine
- patient-centered medicine
- evidence-based medicine
bedside to laboratory medicine
focused on manifestation of disease - not its internal and hidden causes
- emphasis on pathology and underlying causes
patient-centered medicine
- medicine shifted towards establishing an objective effectiveness of practice
- combine biological, psychological, and social perspective of patients
parson’s model of the sick role:
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
parson’s model of the doctor’s role
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
how can stability cause heath care organizations to be functional?
when patients return to social activities then the whole society is stable, and thus functional
what conflicts may be observed, in spite of these two roles
- 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
4 types of doctor-patient relationships
- paternalistic relationship
- mutuality
- consumerist
- default
paternalistic relationship
high doctor control, low patient control
mutuality
equal control
consumerist
low doctor control, high patient control
(might be found in private consultations)
default
low doctor control, low patient control
most common types of doctor-patient relationships
paternalistic and mutuality
younger and highly educated patients expect a more
patient-centered consultation
how did medical consultations change over time?
traditionally doctors wanted to understand the symptoms and the patient’s experiences, which recently changed to making patients more involved
3 main models of treatment decision-making
- professional choice (doctor decides)
- shared choice (to achieve concordance)
- consumer choice (patient decides)
why might patients not prefer to have a shared choice?
when patients are in crisis, they prefer the decision to be made for them
basic communication skills for history taking
- initiate the consultations
- consent and confidentiality
- use of closed and open questions
- check patients’ perspective
- empathize
- signpost
- check patient’s understanding
- summarize
9 . close the consultation
initiate the consultations
- introduce yourself
- explain the purpose of the consultation
consent and confidentiality
- obtain consent
- ensure confidentiality
use of closed and open questions
closed questions - question that lead to given answers
open questions - which allow patient to narrate
check patient’s perspective
check what the patient think by using an open question
empathize (RAV)
recognize - pick up the cues
accept - non-judgemental
acknowledge - confirm that emotion is there
validate - confirm that the emotion is valid
signpost
prepare the patient of the area you are exploring next
check patient’s understanding
you can ask the patient how they understand medical terms, conditions, if everything is clear, to summarize what you have told them
summarize and close the consultation
- summarize so to make sure that you have understood well
- inform the patient what you plan to do with that information
