The Doctor-Patient Relationship Flashcards
elements of doctor-patient relationship
reality based elements (therapeutic alliance)
fantasy-based elements (transference)
aim is for patient well-being or health maintenance
therapeutic alliance
derived from the patient’s pattern of leaned interpesonal behavior
transference
fundamental to DPR
trust
characteristics of the doctor
medical knowledge understanding of patient situation or value system self-awareness communication skills interview techniques
characteristics of the patient
gender age individual history unique personality member of family belonging to a community
mechanisms affecting the formation of the dpr
assessment and evaluation process development of dp rapport therapeutic or working alliance transference counter transference defense mechanisms
sets the stage for identifying relevant problems in the context of an empathic working alliance with a patient
assessment and evaluation process
evaluating
content
process
spontaneous, conscious feeling of harmonious responsiveness that promotes the development of a therapeutic relationship
rapport
commitment between the doctor and the patient to explore the patient’s problems, to establish mutual trust and to cooperate with each other to achieve realistic goal of a cure or alleviation of symptoms
therapeutic alliance
process of displacing attitudes and feelings originally experienced in relationships with persons from the past
transference
process by which doctors unconsciously ascribe motives or attributes to patients that comes from the doctor’s past relationship
countertransference
specific cognitive processes, ways of thinking, that the mind employs to avoid painful experience
defense mechanisms
models of dpr
paternalistic model
informative model
interpretive model
deliberative model
appropriate for situations where doctors need to take control
paternalistic model
doctor dispenses information but the choice is left to the patient
informative model
appropriate for one-time consultation
informative model
doctor discusses alternatives with patient’s participation
interpretive model
appropriate for those with chronic disease requiring follow-up
interpretive model
doctor acts as a friend or counselor
appropriate in modifying behavior
deliberative model
philosophy and process of care that integrates the specialized knowledge of multiple disciplines
multidisciplinary model
key elements in multidisciplinary approach to medical care
shared purpose and goal roles and responsibilities are clear members make appropriate contributions team members cooperate and coordinate activities members trust one another
rapid speech, think loud, interrupts, louder volume
extroversion
pauses in answering or giving information, thinking things through, shorter sentences
introversion
asks for step-by-step information or instructions, present situation, what and how questions, precise descriptions
sensing
purpose of the action, why question, current and long term implication, general terms and possibilites
intuition
seems to be testing you, weighs up objective evidence, not impressed by the decision of others, logic
thinking
strives for harmony, value, how others have acted or resolved a similar situation
feeling
impatient with overly long descriptions of procedures,
may make decisions prematurely, enjoys getting things done
judging
seems to want space to make decision, may decide at the last moment, enjoys processing
perceiving
adaptive techniques
doctor: extroversion
patient: introversion
slower pace and give time for the patient to reflect
adaptive techniques
doctor: introversion
patient: extroversion
show more energy and give space for the patient to talk
adaptive techniques
doctor: intuition
patient: sensing
give detailed information in a stepwise fashion
adaptive techniques
doctor: sensing
patient: intuition
give big picture first
adaptive techniques
doctor: feeling
patient: thinking
keep to objective facts and logical information
adaptive techniques
doctor: thinking
patient: feeling
take an interest in the patient as an individual, show concern
adaptive techniques
doctor: judging
patient: perceiving
provide space for the patient to explore and clarify the options
adaptive techniques
doctor: perceiving
patient: judging
agree an agenda for action
