The Doctor-Patient Relationship Essay

In his article “Whose Body Is It, Anyway?”—appearing in the New Yorker in October 1994—Dr. Atul Gawande highlights the complexities of the doctor-patient relationship vis-à-vis patient autonomy and decision-making. Dr. Gawande explains that a respect for patient autonomy (i.e., allowing patients to choose between courses of treatment, therefore directly influencing their health outcome) is the “new normal” for medical practitioners. However, Gawande also contends that there are times when patients are better served by a voluntary relinquishment of that autonomy.

There are beliefs and assumptions that can hinder the ability of physicians to build proper relationships with the patient. For me personally, the belies that I hold that may influence my ability to build proper relationships with the patient is control. I believe in shared control rather than doctor control when interacting with the patient.

Although the authors agree with Katz on his view of sense one and sense two, they reason that his model of shared decision making is nothing like informed consent. Shared decision making is when the doctor and the patient reach a conclusion that satisfies them both, but the authors do not agree with this notion because it violates the idea of informed consent by involving the doctor’s opinion. In sense one, the second condition states there should be no manipulation or coercion in true informed consent, and shared decision making does not recognize

The medical model “is a perspective of scientific materialism and the dominant perspective in biological psychiatry. This perspective uses scientific method to explore observable, measurable aspects of the individual”(Elliott Ingersoll, 2016, p. 346). The psychological perspective is “the perspective that represents the subjective experiences of the client. This includes thoughts, feelings, and worldviews as well as such things as mystical or intuitive experiences” (Elliott Ingersoll, 2016, p. 348). The medical model and the psychological model resemble each other by focusing on the brain such as the mind and behavior.

I chose Peplau’s theory because I feel patients must be educated when making health care decisions, and the health care provider is responsible to include patients in making informed health care decisions. The nurse facilitates patients in making a high quality health care decisions by discussing patient perceived complaints, asking the patient about their knowledge of the problem, educating the patient regarding their health care problem, therefore facilitating the patient making quality health care decisions. Patients are more likely to be

Arthur Kelinman developed the explanatory model of illness which incorporates a series of questions that is unique to a patient’s illness to develop a treatment plan. This model assesses how patient illnesses are associated with the environment and the culture around them, while also “seeking the how, why, what, when, where, and what next of illness, disease, and health experience” (“Explanatory Model”). Asking the patient what is their opinion on what caused their illness and how they believe it should be treated will help identify their beliefs and help when planning an intervention.

It focuses on the diagnosis and treatment of the illness, however, in its most narrow form can sometimes fail to address some other important influences on health and wellbeing. The medical model is concerned with the pursuit of cures for the disease.

The Doctor and Patient relationship aspect of Medicine has changed drastically in the last twenty years. It has evolved from paternalism (the doctor makes the decision for the patient) to shared decision making where the patient is considered an equal partner in his/her own health related decisions. Informed consent is the cornerstone for this view. When a patient or a research subject makes an autonomous decision after understanding, the risks and benefits involved with the decision is Informed consent. Complete Informed consent covers the following components: competency, disclosure, comprehension and voluntary. Competency refers to the requirement for the individual to be of legal age and be mentally competent to understand the process.

The Medical Model is the oldest of the three models, historically it started with the shamans, medicine men and mid-wives. The medical model views the persons coming for help as patients, sick or with a disease. Its central focus is the symptoms, diagnosis, treatment and cure of the illness of that disease. (Woodside & McClam, 2015, pg. 103). The medical model was particularly used in the treatment and care of the mentally ill who were often caged and treated like animals. During the time of the French Revolution a Dr. Philippe Pinel campaigned for the rights of the mentally ill, to be treated as patients needing care instead

A1. Models of Health and Healing- The candidate provides a logical discussion, with substantial detail, of the differences between 2 models of health and healing as they relate to what it means to be human.

Shared decision making should involve both health professionals and patients in discussions about their care. “While health professionals hold the expert clinical and technical knowledge, patients are experts about their own lives and treatment objectives, and also what is important to them when making decisions. (Lally, Macphail, Palmer, Blair and Thomsom, 2011).

A twist on the "patient's perspective" approach is to describe a time when medicine failed to save or heal someone close to you. The purpose of this tactic would not of course be to rail against the medical profession, but rather to show how a disappointing loss inspired you to join the struggle against disease and sickness.

Clinical reasoning is concerned with relationships and has concern for those they are caring for (Benner et al., 2008). It is a term used synonymously with decision making and clinical judgement (Simmons, 2010).

Even if patients cannot understand and make true choices, they have relatives such as family or spouse; hence, doctors can tell the truth to their relatives. Therefore, since doctors can simplify their explanations and patients’ family can make choices for them, doctors should always tell the truth.

Through this general acceptance this model allows doctors of the future to have a holistic and humanistic approach towards their patients.