Download COMMUNICATION SKILLS

COMMUNICATION
SKILLS
THE PATIENT –
PRACTITIONER
RELATIONSHIP
THE PATIENT – PRACTITIONER
RELATIONSHIP


What is a human relationship.
Three basic models of the doctorpatient relationship.
1. The model of activity-passivity.
2. The model of guidance-cooperation.
3. The model of mutual participation.


The basic models and the
psychology of the physician.
What is “good medicine”?
What is a human relationship.
Traditionally concerned with “
things”, e.g. bacteria
,anatomical structures.
 In modern times include the
concept of “function”.

What is a human relationship.
Rather it is an abstraction,
appropriate for the
description and handling of
certain observational facts.
 It is an abstraction
embodying the activities of
two interacting systems
(persons).

Three basic models of the doctorpatient relationship.
1.



The model of activity-passivity:
The oldest conceptual model.
Based on the effect of one
person on another, who is
unable to contribute actively.
Underlies the application of
some of the outstanding
advances of modern medicine
(e.g. surgery, antibiotics).
Three basic models of the doctorpatient relationship.
2.



The model of guidance-cooperation.
Underlies much of medical practice.
It is employed in situation which
are less desperate than those
previously mentioned (e.g. acute
infection).
The patient is expected to “look up
to” and to “obey” his doctor.
Three basic models of the doctorpatient relationship.
3.


A.
B.
C.
The model of mutual participation:
Based on that equality among
human beings is desirable.
The participants ;
Have approximately equal power.
Be mutually interdependent.
Engage in activity that will be in
some ways satisfying to both.
Three basic models of the doctorpatient relationship.
MODEL
PHYSICIAN’S PATEINT’S
ROLE
ROLE
CINICAL
PROTOTYPE
APPLICATION OF MODLE
OF MODLE
Activitypassivity
Does
Recipient
something to (unable to
patient
respond)
Anesthesia
,acute
trauma,
coma ,etc.
Parentinfant
Cooperator Acute
(obeys)
infectious
processes,
etc.
Parentchild.
GuidanceTells patient
cooperation what to do.
Mutual
participatio
n
Helps patient Participant
to help
in
“partnershi
himself.
p”
Most chronic Adult-adult
illnesses,
psychoanalysis, etc.
Three basic model and the
psychology of the physician
A physician is simply
motivated by a wish to help
others, no scientific study of
the subject can be
undertaken.
 In the activity-passivity
model physician contributes
to feelings of superiority.

Three basic model and the
psychology of the physician

In the guidance-cooperation
model physician has an
opportunity to recreate the
“Pygmalion complex”. Thus,
the physician can mold others
into his own image.
Three basic model and the
psychology of the physician
In the mutual participation, the
physician's gratification cannot stem
from power.
 The doctor-patient relationship must
change according to patient health
progress.
 the physician’s inner needs are most
likely to interfere with what is “best”
for the patient.

WHAT IS “GOOD MEDICINE”?
GOOD means whether or not the
object under consideration satisfies
us.
 In activity-passivity model and
guidance-cooperation, the treatment
means whatever the physician does.
 In mutual participation the treatment
means an abstraction of one aspect
of the relationship, embodying the
activities of both participants.
