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Chapter 8

HSS 3332 Chapter Notes - Chapter 8: Biopsychosocial Model, Gabi Balint, Paternalism

Health Sciences
Course Code
HSS 3332
Sarah Fraser

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Pearce et al. (2017). Computers, patients, and doctors-Theoretical and practical
What are the differences between the doctor dominant paradigm and the biopsychosocial
Doctor dominant paradigm: a very doctor-centric approach, where the doctor did things
to patients; whether they used themselves, or drugs, or other procedures; Balint
Biopsychosocial model: George Engels; shifted the focus from diseases doing something
to a person, to illnesses as something being experience by a person; should include both
psychological and social issues
What are the six key components of the Patient Centered Clinical Method?
Exploring both the disease and the illness experience
Understanding the whole person
Finding common ground
Incorporating prevention and health promotion
Enhancing the doctor-patient relationship
Being realistic
Name and define the four ideal types of doctor-patient relationships.
Emanuel and Emanuel: notion of the ideal types of doctor-patient relationships
Paternalistic: parental or priestly model; doctor acts as the patient’s guardian,
articulating and implementing what they feel is in the patient’s best interest
Informative: scientific, engineering or consumer model; obligation here is for the
doctor to provide all the available facts, and then the patient, with their own value
set, determines the outcome
Interpretive: here the aim is for the doctor to elucidate the patients’ value system,
and thereby help select the best intervention
Deliberative: Doctor acts as a teacher or friend
What types of power influence the doctor-patient relationship?
Dependence: patient’s place in the consultation; dominance of the medical
profession in its interactions with the patient’s foes considerably beyond simply
the rational foundations provided by science; spills over its clinical boundaries
into an arena of moral and political action for which judgment is only partially
Types of power: consider the extent to which the relationship revolves around
four elements or types of power
Structural power: arises from the speaker’s affiliation with the social
institution of medicine
Charismatic power: based on personal characteristics
Social power: based on social prestige
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