The changing face of the doctor-patient relationship

Handshake-With-DoctorThe Patient-Physician Relationship is Health Care’s Touchstone.

The patient-physician relationship is fundamental to providing and receiving excellent care in the healing process and to improve disease outcomes. The physician has always been recognized and accepted as the guardian who uses his specialized knowledge and training to benefit patients, including deciding unilaterally what constitutes a benefit. The relationship therefore resembles that between a wise and caring father and his child, hence the use of the term “paternalism”.

Key Point: The relationship between doctors and patients is changing. Patients are more informed and want to take an active role in their care, but they still need the guidance of their doctors to make the best decisions.

As we enter the 21st century, however, the nature of the patient-physician relationship appears to be far more complex. Today the “voice of the patient” has become one of the key drivers of the changing healthcare environment. Increasingly, patients are not simply recipients of care or subjects of research, but they are active and informed individuals who wish to know more about their conditions and exert greater control over their own care.

So a model advocating supremacy of individual freedom and autonomy is emerging, labeled by some as the “informative model”, where the doctor only provides the patient with relevant information, leaving the patient to make decisions on his own. The advantage of this model is that patients are empowered as active participants in the decision-making process, but the physician’s role in this medical encounter is no more than a passive information provider.

It was observed that it may be more harmful for patients to exercise their rights of autonomy to overrule doctors’ choices, as all patients might not be prepared to take up this charge of self-decision. So a “deliberative model” defines the physician as a teacher and a friend, who helps to formulate plans and take decisions that are more easily followed.

Such a model that provides for professional guidance is especially relevant in this Internet age, where patients are flooded with information, some of which is...

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