What is meant by being a Patient?
A person who has physical or mental ailment which can lead to some dissociation between body and mind. This state makes the person vulnerable, stressed, anxious, scared with lot of expectations and demands from the healthcare provider. From here evolves a special bonding when a prospective patient seeks the advice, care, and/or treatment of a physician. This is Physician-Patient Relationship.
The physician is readily recognized and accepted as the guardian who uses his specialized knowledge and training to benefit patients, including deciding unilaterally what constitutes a benefit. Until about 30 years ago, it was the typical mode of medical practice. One advantage to this approach was that patients did not have to bear the burden of decision making.
According to Med J of Bioethics, 2004 this “paternalistic model” of medical decision-making have treated the patient alone outside of his or her social context as the subject in the physician-patient relationship.
In the “informative model”, the role of the physician is relegated to that of a technical specialist who only provides the patient with the relevant information, leaving the patient to decide on his own. The advantage of this model is that patients are empowered as active participants in the decision making process.But this may be more harmful for patients to exercise their rights of autonomy to overrule doctor’s choice.
These two models may be viewed as two extremes of a swinging pendulum.
Many patients may not be prepared or ready for absolute autonomy, and may be best served by a model called “guided paternalism” whose objective is to strive to enhance and optimize the patient’s autonomy.
So in the “deliberative model” the final say ultimately reside with the patient who has to live with the consequences of the medical decision and the physician is seen as a teacher and a friend who helps the patient in value clarification and in processing the various potential interventions.
The aim is not only to discuss what the patient could do, but also what the patient should do in a particular situation. This will help the patient to formulate plans and make decisions that are most authentic and relevant to him. Such a model that provides for professional guidance is especially relevant in this Internet age, where patients are flooded with information, some of which are unprocessed and lack validation.
The physician needs to cultivate a partnership with the patient, and together negotiate a management plan which allows for physician’s professional recommendations and for patient’s ideas, concerns and expectations.
In this relationship doctors are medical experts and patients are personal experts. Each participant learns from each other’s expertise and using that gained knowledge arrive at a mutually agreeable treatment plan.
It is important for physicians to acquire effective patient centered communication skills that are essential tools to promote patient understanding and participation.
This model of care can be described using various terms -- empowerment, informed choice, patient centered where patient is at the center and is actively involved in his or her own health care.
A person who has physical or mental ailment which can lead to some dissociation between body and mind. This state makes the person vulnerable, stressed, anxious, scared with lot of expectations and demands from the healthcare provider. From here evolves a special bonding when a prospective patient seeks the advice, care, and/or treatment of a physician. This is Physician-Patient Relationship.
The physician is readily recognized and accepted as the guardian who uses his specialized knowledge and training to benefit patients, including deciding unilaterally what constitutes a benefit. Until about 30 years ago, it was the typical mode of medical practice. One advantage to this approach was that patients did not have to bear the burden of decision making.
According to Med J of Bioethics, 2004 this “paternalistic model” of medical decision-making have treated the patient alone outside of his or her social context as the subject in the physician-patient relationship.
In the “informative model”, the role of the physician is relegated to that of a technical specialist who only provides the patient with the relevant information, leaving the patient to decide on his own. The advantage of this model is that patients are empowered as active participants in the decision making process.But this may be more harmful for patients to exercise their rights of autonomy to overrule doctor’s choice.
These two models may be viewed as two extremes of a swinging pendulum.
Many patients may not be prepared or ready for absolute autonomy, and may be best served by a model called “guided paternalism” whose objective is to strive to enhance and optimize the patient’s autonomy.
So in the “deliberative model” the final say ultimately reside with the patient who has to live with the consequences of the medical decision and the physician is seen as a teacher and a friend who helps the patient in value clarification and in processing the various potential interventions.
The aim is not only to discuss what the patient could do, but also what the patient should do in a particular situation. This will help the patient to formulate plans and make decisions that are most authentic and relevant to him. Such a model that provides for professional guidance is especially relevant in this Internet age, where patients are flooded with information, some of which are unprocessed and lack validation.
The physician needs to cultivate a partnership with the patient, and together negotiate a management plan which allows for physician’s professional recommendations and for patient’s ideas, concerns and expectations.
In this relationship doctors are medical experts and patients are personal experts. Each participant learns from each other’s expertise and using that gained knowledge arrive at a mutually agreeable treatment plan.
It is important for physicians to acquire effective patient centered communication skills that are essential tools to promote patient understanding and participation.
This model of care can be described using various terms -- empowerment, informed choice, patient centered where patient is at the center and is actively involved in his or her own health care.
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