Drjunewilliamscolsma : Doctor-patient relationship and patient interview
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This document discusses key aspects of the doctor-patient relationship and clinical interviews. It covers the placebo effect, transference, countertransference, models of the doctor-patient relationship, empathy, and conducting a clinical interview. The placebo effect is a psychological and chemical response that can transform an anticipated effect into a real effect. Transference and countertransference refer to emotional responses patients and doctors have towards each other based on past relationships. Effective doctor-patient relationships balance the roles of each party. Empathy is the ability to understand another's feelings by sharing them. Clinical interviews should make the patient comfortable and invite them to discuss their chief complaint in their own words.
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Drjunewilliamscolsma : Doctor-patient relationship and patient interview
- 1. Doctor-Patient Relationship and Initial Patient Interview Dr June Williams Colsman M.D. of Medicine
- 3. Some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician. Physician
- 4. Placebo Effect Placebo Effect is a combination of a psychological expectation blended with a neuron chemical response that transforms an anticipated effect into a real effect
- 5. Placebo Response At least 20-30 % of patients have been shown to respond to treatment with placebo Placebo pain response can be blocked by naloxone which suggests it is mediated by the endogenous opioid system
- 6. Transference Expectation, beliefs and emotional responses that the patient brings to the doctor-patient relationship based on important relationships in the patient’s past
- 7. Positive Transference Patient views doctor as good and has confidence in his or her ability Can lead to over idealization and tremendous disappointment when doctor can’t solve all problems or is not always available.
- 8. Negative Transference Patient views doctor as harsh punitive parent or authoritative figure who doesn’t care about well being and patient may be non-compliant. Patient with experience with untrustworthy parent may seek many consultations and may be provocative to doctors
- 9. Countertransference Refers to doctor’s reaction towards patient based on their own earlier experience Doctors can feel guilty when they are unable to help patient Doctor may have feelings towards patient who remind them of close relative or friend.
- 10. Models of Doctor Patient Relationship Model Physician's Role Patient's Role Application Prototype Activity- Passivity Autocratic Warm/detached Dominant Passive Critical care or acute Patient needs strong figure Parent-Infant Parent-Child Guidance- Cooperation Warm/detached Makes plans Advises Informative Cooperates but may be given choices Above but more likely subacute, chronic care & minor illness Parent-Child Parent- Adolescent Mutual- Participation Usually warm Discusses plan Interactive Helps patient help self Interpretive Patient uses expert but is active in own care Interactive Possible with most of above- more likely in chronic care and psychotherapy Elements of above but mostly Adult-Adult
- 11. Empathy The ability to momentarily experience the the feelings of another person ( put yourself in another person’s place. Transiently experience feelings of the patient and use those feelings to gain understanding of the the patient’s subjective experience Communication of that understanding to the patient
- 12. Empathy -Components Transiently experience feelings of the patient and use those feelings to gain understanding of the the patient’s subjective experience Communication of that understanding to the patient
- 13. Clinical Interview The Interview Process The Interview Process INE HRAA-VF- WAY5 To MAV WE mvF- WAY5TOMA14F- ~ WE RA.VF-
- 14. Clinical Interview Be Polite Introduce yourself to patient Make the patient comfortable Initial Question-Invite the patient to tell you how he or she came to be in the hospital (chief complaint ).