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A Clinimetric Approach to the Components of the Patient-Physician Relationship

A Clinimetric Approach to the Components of the Patient-Physician Relationship Although patient-physician relationships have been expressed with diverse concepts and models, we have formulated a clinimetric classification derived from several years of observation and discussions at weekly housestaff conferences devoted to "difficult" patients. The observed phenomena are classified into the following components: (1) background factors intrinsic to patient and physician before they meet, (2) individual anticipations and hopes for what may happen, (3) extrinsic features of the setting, (4) individual reactions during the encounter, and (5) the consequences thereafter. These interacting components are usually too complex for characterizations based on single models for the relationship or single titles (such as "hateful" or "noncompliant") for the patient. The components can serve as a "review of systems" for identifying manifestations, sources, and solutions to such common problems as discordant hopes, the physician's unawareness of the patient's pertinent extramedicai status, psychiatric and mental-status challenges, and cogent factors in chronic illness. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

A Clinimetric Approach to the Components of the Patient-Physician Relationship

Sledge, William H.; Feinstein, Alvan R.
JAMA , Volume 278 (23) – Dec 17, 1997
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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1997.03550230019007
Publisher site
See Article on Publisher Site

Abstract

Although patient-physician relationships have been expressed with diverse concepts and models, we have formulated a clinimetric classification derived from several years of observation and discussions at weekly housestaff conferences devoted to "difficult" patients. The observed phenomena are classified into the following components: (1) background factors intrinsic to patient and physician before they meet, (2) individual anticipations and hopes for what may happen, (3) extrinsic features of the setting, (4) individual reactions during the encounter, and (5) the consequences thereafter. These interacting components are usually too complex for characterizations based on single models for the relationship or single titles (such as "hateful" or "noncompliant") for the patient. The components can serve as a "review of systems" for identifying manifestations, sources, and solutions to such common problems as discordant hopes, the physician's unawareness of the patient's pertinent extramedicai status, psychiatric and mental-status challenges, and cogent factors in chronic illness.

Journal

JAMA – American Medical Association

Published: Dec 17, 1997

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