Week 12a Flashcards
three types of practicing medicine which
associate with doctor-patient relationships
- From bedside to laboratory medicine
- Patient-centred medicine
- Evidence-based medicine
From bedside to laboratory medicine
➢ Overtime, more and more patients were hospitalised
➢ Centralised approach to medicine – consensus to
diagnosis and therapy
➢ Emphasis on pathology and underlying causes
➢ Shift to laboratory medicine – the importance of laboratory
tests
Evidenced-based medicine
➢ In the past clinical experience guided treatment – if a drug
worked in clinical practice it was then used again
➢ The shift in recent times is toward establishing an
objective effectiveness of practice and treatment
➢ Evidence from research and trails, not from everyday
practice
Patient-centred medicine
➢ Since the 1980s, there has been asystematic turn to “patient centred” medicine – combined biological, psychological and social perspective
➢ Patients provide information for diagnosis but are actively engaged in the management of his/ her condition
➢ Nowadays people have chronic diseases and a patientcentred approach is more appropriate – long-term
collaboration with doctors
(2. Social Roles of Doctors and Patients)
Parson’s model of the sick role Obligations/ Expectations of Patients?
Rights?
Obligations/ Expectations
➢ Patients must want to get well as quickly as possible
➢ They should seek medical help
Rights
➢ Allowed to withdraw from daily activities
➢ Regarded as unable to get better by his own decision and
will
(2. Social Roles of Doctors and
Patients)
The Doctors’ Role
Obligations/
expectations
Rights?
Obligations/ expectations
➢ Apply high degree of skills and knowledge
➢ Act for the good of patients and community
➢ Be objective and emotionally detached
➢ Be guided by rules of professional practice
Rights
➢ Granted rights to examine patients physically
➢ Granted autonomy in medical practice
➢ Has a position of authority in relation to the patient
Talcott Parsons used these roles for What?
➢ Talcott Parsons used these roles to show how can stability
be achieved in healthcare organisations
➢ Due to stability, health care organisation can be functional
➢ Because patients can return to social activities then the
whole society is stable and thus functional
(2. Social Roles of Doctors and Patients)
Conflicts in the Social Roles of Doctors and
Patients
➢ Different values between doctors and patients
➢ Confidentiality (doctors may breach it outside any guidelines and before informing the patient)
➢ Doctors may not be able to determine the cause of patients’
symptoms – patients may be frustrated
➢ Doctors may not be able to coordinate effectively objective
treatment, a patient-centred approach, and a cost-effective
treatment for the healthcare system
(3. Models of Doctor-Patient Relationships)
4 types of relationships between doctor- patient
• Paternalistic relationship: high doctor control, low
patient control
• Mutuality: equal control
• Consumerist: low doctor control, high patient control
(this might be found in private consultations)
• Default: low doctor control, low patient control
What is the most popular patient Doctor relationship?
Paternalistic and mutuality are the most common types
Doctor-Patient
Relationships extended
➢ Doctors perceptions’ of their role and their patients’ role is an influential factor for the type of doctor-patient relationship
➢ Patients’ expectations play their role: younger and highly educated patients expect a more patient-centred
consultation
➢ Medical practice is also guided by professional directives
and guidelines
Summary
➢ The way medicine is practiced has been changed in the
last two centuries from bedside to evidence-based
➢ Both doctors and patients have specific social roles to
perform
➢ Doctor-patient relationship is determined by the power and control they have => 4 types of relationships
➢ These relationships are influenced by other factors, such
as doctors and patients expectations, as well as professional directives
