scholarly journals The Doctor as Parent, Partner, Provider… or Comrade? Distribution of Power in Past and Present Models of the Doctor–Patient Relationship

2021 ◽  
Author(s):  
Mani Shutzberg
Keyword(s):  
Patient Relationship ◽  
Sickness Certification ◽  
Doctor Patient Relationship ◽  
Partnership Model ◽  
Distribution Of Power ◽  
Consumer Model ◽  
Patient Relationships ◽  
Point Of Departure

AbstractThe commonly occurring metaphors and models of the doctor–patient relationship can be divided into three clusters, depending on what distribution of power they represent: in the paternalist cluster, power resides with the physician; in the consumer model, power resides with the patient; in the partnership model, power is distributed equally between doctor and patient. Often, this tripartite division is accepted as an exhaustive typology of doctor–patient relationships. The main objective of this paper is to challenge this idea by introducing a fourth possibility and distribution of power, namely, the distribution in which power resides with neither doctor nor patient. This equality in powerlessness—the hallmark of “the age of bureaucratic parsimony”—is the point of departure for a qualitatively new doctor–patient relationship, which is best described in terms of solidarity between comrades. This paper specifies the characteristics of this specific type of solidarity and illustrates it with a case study of how Swedish doctors and patients interrelate in the sickness certification practice.

Boundaries of reasoning in cases: The visual psychoanalysis of René Spitz

2020 ◽  
Vol 33 (3-4) ◽  
pp. 66-84
Author(s):  
Rachel Weitzenkorn
Keyword(s):  
Experimental Psychology ◽  
Developmental Psychology ◽  
Patient Relationship ◽  
Visual Displays ◽  
Doctor Patient Relationship ◽  
Interpersonal Emotions ◽  
The Individual ◽  
Key Aspects

This article argues that the foundational separation between psychoanalysis and experimental psychology was challenged in important ways by psychoanalytic infant researchers. Through a close examination of American psychoanalyst René Spitz (1887–1974), it extends John Forrester’s conception of reasoning in cases outside classic psychoanalytic practices. Specifically, the article interrogates the foundations of reasoning in cases—the individual, language, and the doctor–patient relationship—to show how these are reimagined in relation to the structures of American developmental psychology. The article argues that the staunch separation of experimental psychology and psychoanalysis, reiterated by philosophers and historians of psychology, is flimsy at best—and, conversely, that the maintenance of these boundaries enabled the production of a cinematic case study. Spitz created films that used little language and took place outside the consulting room with institutionalized infants. Yet key aspects of the psychoanalytic case, as put forth by John Forrester, were depicted visually. These visual displays of transference, failure, and interpersonal emotions highlight the foundations of what Forrester means by reasoning in cases. The article concludes that Spitz failed at creating classic psychoanalytic evidence, but in so doing stretched the epistemology of the case.

Patients' Influence on Doctors' Behavior: A Case Study of Patient Strategies in Somatization

1995 ◽  
Vol 25 (4) ◽  
pp. 319-329 ◽  
Author(s):  
Peter Salmon ◽  
Carl R. May
Keyword(s):  
Empirical Data ◽  
Single Case ◽  
Psychological Needs ◽  
Biomedical Model ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Social Distress ◽  
Powerful Explanation

Objective: Extensive empirical data and theory describe the inequality of power in relations between doctors and their patients. However, the focus has been on the ways in which doctors control the doctor-patient relationship. This has meant that the extent to which patients influence the consultation, and the ways in which they do this, have been neglected. Methods: In this article, we use a single case to identify and illustrate distinct ways in which patients exert power to determine the outcome of consultations. Conclusion: This analysis leads to a more powerful explanation than is presently available to understand the somatization of psychological needs. According to this, the patient organizes strategies, which include the presentation of emotional and social distress, around a biomedical model. Because of their prior decisions as to their role, doctors permit themselves to be trapped in this model.

Doctor–patient relationship mediates the effects of shared decision making on health-related quality of life among women living with breast cancer

2018 ◽  
Vol 49 (3) ◽  
pp. 364-375 ◽  
Author(s):  
Nuworza Kugbey ◽  
Kwaku Oppong Asante ◽  
Anna Meyer-Weitz
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Decision Making ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Cross Sectional ◽  
Patient Relationships

Decreased quality of life is a major challenge among women living with breast cancer due to treatment effects and other psychosocial comorbidities. However, shared decision making and doctor–patient relationship have been linked to improved quality of life, but the mechanism linking shared decision making and quality of life is poorly understood. This study therefore examined both the direct and indirect influences of shared decision making on quality of life through doctor–patient relationship among 205 women living with breast cancer in Ghana with a mean age of 52.49 years. Using a cross-sectional design, participants were administered questionnaires which measured quality of life, doctor–patient relationship, and shared decision making. Results showed that shared decision making had significant indirect influence on overall quality of life via doctor–patient relationships ( b = 4.69, 95% confidence interval = [0.006, 9.555]). Shared decision making had a significant effect on doctor–patient relationships ( b = 7.63, t = 6.76, p < .001) but no significant direct effect on quality of life ( b = 2.72, t = 0.510, p = .61). Findings suggest that shared decision making results in improved doctor–patient relationships which probably lead to better quality of life among women living with breast cancer. These findings underscore the need for increased patient involvement in medical decisions to improve interpersonal relationships and consequently quality of life.

Doctor image on People's Daily Weibo and its impact on the doctor-patient relationship:content analysis (Preprint)

2019 ◽  
Author(s):  
Guobing Qiao ◽  
Mingjing Lei ◽  
Jie Zhu ◽  
Qunyou Tan
Keyword(s):  
New Media ◽  
Patient Relationship ◽  
Media Images ◽  
Doctor Patient Relationship ◽  
Chinese Media ◽  
Medical Reform ◽  
Content Analysis Method ◽  
People’S Daily ◽  
People's Daily ◽  
Patient Relationships

BACKGROUND Since the 2009 medical reform in China, the doctor-patient relationship seems to be an increasingly serious issue. And with the new media era, Weibo is one of the most important platforms for building the doctor image. However, no studies have focused on how China official media Weibo reports on doctor-patient issues. OBJECTIVE The aim of this study was to study the presentation of doctor image on People's Daily Weibo and how it affects the direction of the doctor-patient relationship. METHODS This study used a content analysis method and collected data from 01 January 2016 to 31 December 2018 on People's Daily Weibo. Through the characteristics, these postings were categorized into four-doctor images. RESULTS A total of 216 postings about the doctor image were collected on People's Daily Weibo. It was reported 122 postings on positive doctor image, up to 56%, while the number of negative doctor image postings is 15, accounting for only 7%. 44 postings about victim doctor image, accounting for 21%. There are about 25 medical disturbances. People’s Daily Weibo has reported 35 postings that have a neutral image of doctors, accounting for 16%. CONCLUSIONS People’s Daily Weibo has shaped four-doctor media images in the past three years. Moreover, it has mostly reported postings with a rigorous attitude, but some also exaggerate the facts leading to unreal. People’s Daily, the official Chinese media, actively embraces new media by using Weibo to shape doctor media images to influence the harmony of doctor-patient relationships.

scholarly journals Mobile Information Systems Usage and Doctor-Patient Relationships: An Empirical Study in China

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Xin Zhang ◽  
Liang Ma ◽  
Yanbo Ma ◽  
Xiao Yang
Keyword(s):  
Structural Equation ◽  
Equation Model ◽  
Patient Relationship ◽  
Service Model ◽  
Doctor Patient Relationship ◽  
System Use ◽  
Mediator Role ◽  
Mobile Information Systems ◽  
Appointment System ◽  
Patient Relationships

How to improve the doctor-patient relationship has been a continuing topic in academia and management and there have been several attempts to utilize online communications to facilitate healthcare. The application of information technology to create an “Internet + medical care” platform has upended the traditional medical service model in China. As an example of the application of the Internet by the healthcare system, this paper investigates a mobile online appointment system used by hospitals. Data on system use came from questionnaires submitted by 225 patients and analyzed by the structural equation model method. The results showed that patients perceived the hospital’s online appointment system as an attempt at transparency to which they reacted positively. The patients’ perception of transparency promoted trust in the hospital and the doctors and positively affected their feelings of satisfaction, which, of course, improved the doctor-patient relationship. Patients’ perceptions of transparency, trust in the hospitals and doctors, and feelings of satisfaction played a partial mediator role between the availability of an online appointment system and better doctor-patient relationships. There were significant gender differences among patients in terms of their feelings of trust and satisfaction with the new appointment method and whether it really improved the doctor-patient relationship.

scholarly journals Fundamentos humanísticos na formação de estudantes de medicina: estudo de caso

2018 ◽  
Vol 2 (1) ◽  
pp. 19
Author(s):  
Luiz Alberto Queiroz ◽  
Nara Lima Alexandre
Keyword(s):  
Death And Dying ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Doctor Patient Relationship ◽  
Student Community ◽  
Documentary Analysis ◽  
School Of Medicine ◽  
The Subject ◽  
Physician Patient

Background: Medicine has been gaining high technological power, essential for many diagnoses and current treatments. On the other hand, one observes the distancing of the physician from what should be his instrument of work: the person.  Bahiana School of Medicine has been implementing actions aimed at integrating the student into the subjective elements of medical practice through such subjects as the Psychodynamics of the Medical Clinic. Objectives: To portray the reality of the teaching of the discipline Psychodynamics in the Bahiana School of Medicine and Public Health; to evaluate the performance of the psychodynamic material taught in the 7th semester of the medical course, as well as the need to teach humanistic fundamentals to the student community of this school. Methods: Case study conducted through documentary analysis, interview with professor of the subject and application of questionnaire. After approval by the Ethics Committee, questionnaires containing sex, age, year of the course, questions related to the subjects developed in the subject were applied, such as doctor-patient relationship, death and dying, medical vocation and humanization etc. Results: The goal of psychodynamics is to provide an integral view of the patient. The questionnaires were answered by 124 students distributed between the 4th, 5th and 6th grades. 88.7% agreed that the subject provided grounds for establishing an effective physician-patient relationship. 91.2% agreed that the subject drew attention to the therapeutic aspect that can have the doctor-patient relationship. 99.2% agree that in order to meet humanity, it is first necessary to humanize. 86.3% of the students agree on the need to teach humanistic fundamentals throughout the course. Conclusions:A Psicodinâmica da Clínica médica vem atingindo os objetivos propostos. Há necessidade do ensino de fundamentos humanísticos durante todo curso de medicina.Background:Medicine has been gaining high technological power, essential for many diagnoses and current treatments. On the other hand, one observes the distancing of the physician from what should be his instrument of work: the person.  Bahiana School of Medicine has been implementing actions aimed at integrating the student into the subjective elements of medical practice through such subjects as the Psychodynamics of the Medical Clinic. Objectives:To portray the reality of the teaching of the discipline Psychodynamics in the Bahiana School of Medicine and Public Health; to evaluate the performance of the psychodynamic material taught in the 7th semester of the medical course, as well as the need to teach humanistic fundamentals to the student community of this school. Methods: Case study conducted through documentary analysis, interview with professor of the subject and application of questionnaire. After approval by the Ethics Committee, questionnaires containing sex, age, year of the course, questions related to the subjects developed in the subject were applied, such as doctor-patient relationship, death and dying, medical vocation and humanization etc. Results: The goal of psychodynamics is to provide an integral view of the patient. The questionnaires were answered by 124 students distributed between the 4th, 5th and 6th grades. 88.7% agreed that the subject provided grounds for establishing an effective physician-patient relationship. 91.2% agreed that the subject drew attention to the therapeutic aspect that can have the doctor-patient relationship. 99.2% agree that in order to meet humanity, it is first necessary to humanize. 86.3% of the students agree on the need to teach humanistic fundamentals throughout the course. Conclusions: A Psicodinâmica da Clínica médica vem atingindo os objetivos propostos. Há necessidade do ensino de fundamentos humanísticos durante todo curso de medicina.

The internet—A useful communication tool but no replacement for the doctor-patient relationship

2001 ◽  
Vol 120 (5) ◽  
pp. A735-A735
Author(s):  
C STREETS ◽  
J PETERS ◽  
D BRUCE ◽  
P TSAI ◽  
N BALAJI ◽  
...  
Keyword(s):  
The Internet ◽  
Patient Relationship ◽  
Communication Tool ◽  
Doctor Patient Relationship
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