The Relationship Between Patients and Medical Professionals

there are three major views about what the relationship between patient and a medical professional might be.These include:

1. Paternalism

2. Radical individualism

3. The reciprocal view

 

Paternalism is characterized by the statement, "The doctor always knows best". Essentially, the physician acts as a patient's parent by making all the decisions. Paternalism can be further divided into the engineering model or priestly model.

 

In the priestly model, medical professionals are seen as infallible "icons". By virtue of their advanced education, they must be right. They should benefit the patient and do no harm to the patient.

 

In the engineering model the medical professional treats the patient as a "malfunctioning" biological machine that needs to be "fixed". In this model value judgments are irrelevant as are emotions on either side. So, this model is a value free and purely scientific model.

 

Some factors that encourage people to support paternalism are: patient can be confused by complex information, patients don't want to hear the information, patients shouldn't be frightened by medical professionals, the odds of a poor outcome are usually rare, describing side effects can cause them to occur in a patient (power of suggestion). This particularly applies to informed consent.

 

 

Informed consent:

1. Explains the procedure

2. Explains the pain associated before, during and after the procedure

3. Explains the possible complications

4. Explains how long the procedure should take

 

GO BACK TO THE COURSE CONTENT, UNIT 2 AND CLICK ON AN INFORMED CONSENT!!! READ THROUGH THE INFORMED CONSENT AND THEN COME BACK TO THE LESSON!

 

Radical individualism is at the opposite end of the spectrum. It suggests that since patients have absolute rights over their own bodies, they should be able to reject any and all recommendations by medical personnel. In essence, all discussions are in the hands of the patients. Justification for this is that doctors are human and they can make mistakes.

The reciprocal view is referred to as the "team approach". Patients and their families are key members of the team and all healthcare professionals work together for the good of the patient. In this view, should the relationship be one of equality between the patient and the medical professional or perhaps a verbal or written contract between two individuals? Written contracts would include forms like the durable power of attorney, consent forms and do not resuscitate forms. Do you enter into a contract when you work with a patient? The contract you enter into with the patient is that you will take care of the him/her and get the best possible images.

 

What kinds of questions do you think a patient has a right to ask? Which ones can you answer?

 

One family practice doctor in Seattle furnished his patients with a list of questions to ask. The list included:

1. What is wrong with me?

2. What caused it?

3. What should be done about it?

4. What will it cost?

5. How long will it take?

6. What test should be done and why?

7. What is my prognosis?

8. What will you do next?

9. Is it necessary?

10. Is it dangerous?

11. Do I have any alternatives? if so, what are they?

12. If I must go into the hospital, how long will I be there?

13. How long will I be laid up and when can I go back to school or work?

 

A list of questions can really help to stimulate communication between doctors and patients and also enhance the doctor-patient relationship. This list of questions would be answered by a physician. Radiologic Technologists must be careful with the information that they give to a patient. We do not give results of images or medical imaging studies to patients. It is out of the scope of our practice to read any image. We can and should let the patient know that the Radiologist will read his/her images and send a report to his/her doctor.