Session 9 - Patients Evaluations of Healthcare and Relationships between Patients and professionals

Question 1

What is local healthwatch?

Answer 1

• Independent networks of individuals or community groups
• Aim to ensure that each community has services that reflect the needs and wishes of local people.
• Making recommendations to those who plan and run services.

Question 2

What is Patient Advice and Liaison Services?

Answer 2

• On the spot help about health services.
• Listen to patients’ concerns, suggestions and experiences
• Provide an early warning system by identifying problems or gaps in services
• Provides info on NHS complaints procedure

Question 3

How can you investigate patient views directly and indirectly?

Answer 3

Directly:

• Qualitative methods
• Quanititative methods

Indirectly:

• Patient complaints
• Ombudsman’s reports

Question 4

Why should one be critical of patient satisfaction?

Answer 4

Sometimes patients views are unreasonable and irrational

Question 5

What are the pros and cons of using patient based outcomes to assess doctors performance?

Answer 5

Pros - care to patient in the end, therefore should be adequate

Cons - Patients may not have objective view, not applicable on national scale

Question 6

What is the functionalism approach to the patient-doctor relationship? What are criticisms?

Answer 6

The role between doctors and patients is asymmetrical. Whilst the doctor is ‘powerful’, the patient adopts a ‘sick role’. Lay people do not have the technical competence to remedy their situation and thus are placed in a state of helplessness.

Criticism:

• Assumes patients are incompetent and must have a passive role.
• Assumes rationality and beneficence of medicine

Question 7

What is the conflict theroy of understanding patient-doctor relationships? Criticisms?

Answer 7

Conflict theory states that the doctor’s control is not only the product of professional values or technical expertise, but also due to the fact that the doctor holds all the bureaucratic power. Doctors therefore have a monopoly on defining health and illness and the patient has little choice but to submit to the institutionalised dominance of the doctor.

Criticisms:

• Inaccurate portrayal of relationship
• Patients can exert control e.g. via non adherence

Question 8

What is the interpretive theory of understanding the doctor-patient relationship?

Answer 8

These approaches focus on the meanings that both parties give to the encounter. Informal, unwritten rules govern almost every aspect of social life

Question 9

What is the partnership model of understanding doctor-patient relationships?

Answer 9

The aspiration that patient-professional relationships can be less hierarchical and more cooperative if the patients’ view is taken more seriously. It explores the patient’s ICE and seeks an integrated understanding of the patients’ world.

Shared decision making. Concordance.

Question 10

Which of the 4 models doctor-patient models are explanatory and which are aspirational?

Answer 10

1. Functionalism – Explanatory
2. Conflict – Explanatory
3. Interpretive/Interactionism – Explanatory
4. Patient-Centred/Partnership – Aspirational