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Fundamentals of Clinical Practice pp 403–429Cite as

The Patient-Physician Relationship

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  • Cassell EJ: The nature of suffering and the goals of medicine. N Engl J Med 306:639–645, 1982. This is an eloquent exposition of the need for physicians to understand the totality of patients’ experiences and to communicate empathy. It provides guidelines on a clinical approach based on understanding the patient as person.

    Article  Google Scholar 

  • Emanuel EJ, Emanuel LL: Four models of the physician-patient relationship. JAMA 267:2221–2226, 1992; May WF: Code, covenant, contract, or philanthropy? Hastings Cent Rep 5:29–38, 1975; Szasz TS, Hollender MH: The basic models of the doctor-patient relationship. Arch Intern Med 97:585–592, 1956. These three articles are all excellent descriptions of models of the patient-physician relationship. Each takes a different perspective on patient autonomy and the role of the physician.

    Google Scholar 

  • Epstein RM: Mindful practice. JAMA 282: 833–839, 1999. In this article, I propose a model for self-awareness, reflection, and presence that informs technical, interpersonal, and cognitive aspects of medical care.

    Article  Google Scholar 

  • Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR: Patient-Centered Medicine: Transforming the Clinical Method. Thousand Oaks, Calif, Sage Publications Inc, 1995. This book examines the practice of medicine, from theoretical models to the provision of care, from a patient-centered perspective that takes the patient’s experience of illness on equal ground with the physician’s diagnostic perspective.

    Google Scholar 

References

  • Baird MA, Doherty WJ: Risks and benefits of a family systems approach to medical care. Fam Med 22:396–403, 1990.

    Google Scholar 

  • Balint M: The Doctor, His Patient, and the Illness. New York, International Universities Press Inc, 1957.

    Google Scholar 

  • Bass MJ, Buck C, Turner L: Predictors of outcome in headache patients presenting to family physicians—A one year prospective study. Headache 26:285–294, 1986a.

    Google Scholar 

  • Bass MJ, Buck C, Turner L: The physician’s actions and the outcome of illness. J Fam Pract 23:43–47, 1986b.

    Google Scholar 

  • Beckman HB, Markakis KM, Suchman AL, Frankel RM: The doctor-patient relationship and malpractice. Lessons from plaintiff depositions. Arch Intern Med 154:1365–1370, 1994.

    Article  Google Scholar 

  • Beecher HK: Measurement of Subjective Responses. New York, Oxford University Press, 1959.

    Google Scholar 

  • Bellet PS, Maloney MJ: The importance of empathy as an interviewing skill in medicine. JAMA 266:1831–1832, 1991.

    Article  Google Scholar 

  • Bird J, Cohen-Cole SA: The three function model of the medical interview: An educational device, in Hale MS (ed): Methods in Teaching Consultation-Liaison Psychiatry. Basel, Karger, 1990, pp 65–88.

    Google Scholar 

  • Branch WT, Suchman A: Meaningful experiences in medicine. Am J Med 88:56–59, 1990.

    Article  Google Scholar 

  • Brody H: The Healer’s Power. New Haven, Yale University Press, 1992.

    Google Scholar 

  • Brown J, Stewart M, McCracken EC: The patient centered clinical method. II. Definition and application. Fam Pract 3(2):75–79, 1986.

    Google Scholar 

  • Cassell EJ: The nature of suffering and the goals of medicine. N Engl J Med 306:639–645, 1982.

    Article  Google Scholar 

  • Dimsdale JE: Delays and slips in medical diagnosis. Perspect Biol Med 27:213–220, 1984.

    Google Scholar 

  • Doherty WA, Campbell TL: Families and Health. Beverly Hills, Calif, Sage Press, 1988.

    Google Scholar 

  • Doherty WJ, Baird MA: Family Therapy and Family Medicine: Toward the Primary Care of Families. New York, Guilford Press, 1983.

    Google Scholar 

  • Emanuel EJ, Dubler NN: Preserving the physician-patient relationship in the era of managed care. JAMA 273:323–335, 1995.

    Article  Google Scholar 

  • Emanuel EJ, Emanuel LL: Four models of the physician-patient relationship. JAMA 267:2221–2226, 1992.

    Google Scholar 

  • Engel GL: The need for a new medical model: A challenge for biomedicine. Science 196:129–136, 1977.

    Google Scholar 

  • Engel GL: The clinical application of the biopsychosocial model. Am J Psychiatry 137:535–544, 1980.

    Google Scholar 

  • Epstein R: Taking care of. Arch Fam Med 3:9–10, 1994.

    Google Scholar 

  • Epstein RM: Communication between primary care physicians and consultants [see comments]. Arch Fam Med 4:403–409, 1995.

    Article  Google Scholar 

  • Epstein RM: Mindful practice. JAMA 282:833–839, 1999.

    Article  Google Scholar 

  • Epstein RM, Campbell TL, Cohen-Cole SA, McWhinney IR, Smilkstein G: Perspectives on patient-doctor communication. J Fam Pract 37:377–388, 1993.

    Google Scholar 

  • Franks P, Culpepper L, Dickinson J: Psychosocial bias in the diagnosis of obesity. J Fam Pract 14:745–750, 1982.

    Google Scholar 

  • Gabbard GO, Nadelson, C: Professional boundaries in the physician-patient relationship. JAMA 273:1445–1449, 1995.

    Article  Google Scholar 

  • Gerber LA: Career and family dilemmas in doctor’s lives. Fam Med 17:109–112, 1985.

    Google Scholar 

  • Good BJ, Good MD: The meaning of symptoms: A cultural hermeneutic model for clinical practice, in Eisenberg L, Kleinman A (eds): The Relevance of Social Science for Medicine. Dordrecht, Reidel, 1981, pp 165–196.

    Google Scholar 

  • Greenfield S, Kaplan S, Ware JE Jr: Expanding patient involvement in care. Effects on patient outcomes. Ann Intern Med 102:520–528, 1985.

    Google Scholar 

  • Greenfield S, Kaplan SH, Ware JE, Jr, Yano EM, Frank HJ: Patients’ participation in medical care: Effects on blood sugar control and quality of life in diabetes. J Gen Intern Med 3:448–457, 1988.

    Google Scholar 

  • Groves JE: Taking care of the hateful patient. N Engl J Med 298:883–887, 1978.

    Article  Google Scholar 

  • Hahn SR, Feiner JS, Bellin EH: The doctor-patient-family relationship: A compensatory alliance. Ann Intern Med 109(1):884–889, 1988.

    Google Scholar 

  • Havens L: Making Contact. Cambridge, Mass, Harvard University Press, 1986.

    Google Scholar 

  • Kaplan SH, Greenfield S, Ware JE Jr: Assessing the effects of physician-patient interactions on the outcomes of chronic disease [published erratum appears in Med Care 27(7):679, 1989]. Med Care 27:S110–S127, 1989.

    Google Scholar 

  • Karpel MA, Strauss ES: Family secrets, in Karpel MA, Strauss ES (eds): Family Evaluation. New York, Gardner Press, 1983, pp 245–263.

    Google Scholar 

  • Katon W, Kleinman A: Doctor-patient negotiation and other social science strategies in patient care, in Eisenberg L, Kleinman A (eds): The Relevance of Social Science for Medicine. Dordrecht, Reidel, 1981, pp 253–279.

    Google Scholar 

  • Klein D, Najman J, Kohrman AF, Munro C: Patient characteristics that elicit negative responses from family physicians. J Fam Pract 14:881–888, 1982.

    Google Scholar 

  • Kleinman A: The cultural meanings and social uses of illness. J Fam Pract 16:539–545, 1983.

    Google Scholar 

  • Kleinman AM: The Illness Narratives: Suffering, Healing, and the Human Condition. New York, Basic Books Inc, 1987.

    Google Scholar 

  • Kleinman A, Eisenberg L, Good B: Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Ann Intern Med 88:251–258, 1978.

    Google Scholar 

  • La Puma J, Stocking CB, La Voie D, Darling CA: When physicians treat members of their own families. Practices in a community hospital. N Engl J Med 325:1290–1294, 1991.

    Google Scholar 

  • Lazare A: Shame and humiliation in the medical encounter. Arch Intern Med 147:1653–1658, 1987.

    Article  Google Scholar 

  • Lazare A, Eisenthal S, Wasserman L: The customer approach to patienthood. Attending to patient requests in a walk-in clinic. Arch Gen Psychiatry 32:553–558, 1975.

    Google Scholar 

  • Levenstein JH, McCracken EC, McWhinney IR: The patient centered clinical method I. A model for the doctor patient interaction in family medicine. Fam Pract 1:24–30, 1986.

    Google Scholar 

  • Lin EH, Katon W, Von Korff M, Bush T, Lipscomb P, Russo J, Wagner E: Frustrating patients: Physician and patient perspectives among distressed high users of medical services. J Gen Intern Med 6:241–246, 1991.

    Google Scholar 

  • Linklater D, MacDougall S: Boundary issues. What do they mean for family physicians? Can Fam Physician 39:2569–2573, 1993.

    Google Scholar 

  • May WF: Code, covenant, contract, or philanthropy? Hastings Cent Rep 5:29–38, 1975.

    Google Scholar 

  • McDaniel SH, Landau-Stanton J: Family-of-origin work and family therapy skills training: Both-and. Fam Process 30:459–471, 1991.

    Article  Google Scholar 

  • McDaniel SH, Campbell TL, Seaburn D: Managing personal and professional boundaries: How to make the physician’s own issues a resource in patient care. Fam Syst Med 7:1–12, 1989.

    Google Scholar 

  • McDaniel SH, Campbell TL, Seaburn DB: Family-Oriented Primary Care: A Manual for Medical Providers. Berlin, Springer-Verlag, 1990.

    Google Scholar 

  • McKinstry B: Paternalism and the doctor-patient relationship in general practice. Br J Gen Pract 42:340–342, 1992.

    Google Scholar 

  • McWhinney IR: Illness, suffering, and healing, in McWhinney IR (ed): A Textbook of Family Medicine. London, Oxford University Press, 1989a, pp 73–86.

    Google Scholar 

  • McWhinney IR: ‘An acquaintance with particulars...’. Fam Med 21:296–298, 1989b.

    Google Scholar 

  • Mengel M: Physician ineffectiveness due to family of origin issues. Fam Syst Med 5(2):176–190, 1987.

    Article  Google Scholar 

  • Naumberg E, Franks P, Bell B, Gold M, Engerman J: Racial differentials in the identification of hypercholesterolemia. J Fam Pract 36:425–430, 1993.

    Google Scholar 

  • Neighbour R: Paternalism or autonomy? Practitioner 236:860–864, 1992.

    Google Scholar 

  • Newman NK: Family secrets: A challenge for family physicians. J Fam Pract 36:494–496, 1993.

    Google Scholar 

  • Novack DH: Therapeutic aspects of the clinical encounter. J Gen Intern Med 2:346–354, 1987.

    Google Scholar 

  • Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C: Calibrating the physician: Personal awareness and effective patient care. JAMA 278:502–509, 1997.

    Article  Google Scholar 

  • Novack DH, Epstein RM, Paulsen RH: Toward creating physician-healers: Fostering medical students’ self-awareness, personal growth, and well-being. Acad Med 74:516–520, 1999.

    Google Scholar 

  • O’Rourke K: Trust and the patient-physician relationship. Am J Kidney Dis 21:684–685, 1993.

    Google Scholar 

  • Peabody FW: Landmark article March 19, 1927: The care of the patient. By Francis W. Peabody. JAMA 252:813–818, 1984.

    Article  Google Scholar 

  • Pellegrino ED: Is truth telling to the patient a cultural artifact? JAMA 268:1734–1735, 1992.

    Google Scholar 

  • Phillips SP, Schneider MS: Sexual harassment of female doctors by patients. N Engl J Med 329:1936–1939, 1993.

    Article  Google Scholar 

  • Quill TE: Partnerships in patient care: A contractual approach. Ann Intern Med 98:228–234, 1983.

    Google Scholar 

  • Quill TE: Recognizing and adjusting to barriers in doctor-patient communication. Ann Intern Med 111:51–57, 1989.

    Google Scholar 

  • Quill TE, Cassel CK: Nonabandonment: A central obligation for physicians. Ann Intern Med 122:368–374, 1995.

    Google Scholar 

  • Quill TE, Williamson PR: Healthy approaches to physician stress. Arch Intern Med 150:1857–1861, 1990.

    Article  Google Scholar 

  • Rogers CR: The characteristics of a helping relationship, in Rogers CR (ed): On Becoming a Person: A Therapist’s View of Psychotherapy. Boston, Houghton Mifflin, 1961, pp 39–58.

    Google Scholar 

  • Rourke JT, Smith LF, Brown JB: Patients, friends, and relationship boundaries. Can Fam Physician 39:2557–2564, 1993.

    Google Scholar 

  • Rudebeck CE: General practice and the dialogue of clinical practice: On symptoms, symptom presentations, and bodily empathy. Scand J Primary Health Care Suppl, 1992, pp 1–87.

    Google Scholar 

  • Schwenk TL, Romano SE: Managing the difficult physician-patient relationship. Am Fam Physician 46:1503–1509, 1992.

    Google Scholar 

  • Schwenk TL, Marquez JT, Lefever RD, Cohen M: Physician and patient determinants of difficult physician-patient relationships. J Fam Pract 28:59–63, 1989.

    Google Scholar 

  • Simpson M, Buckman R, Stewart M, Maguire P, Lipkin M, Novack D: Doctor-patient communication: The Toronto consensus statement. Br Med J 303:1385–1387, 1991.

    Google Scholar 

  • Spiegel D, Kraemer H, Bloom J, Gottheil E: Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet (ii):888–891, 1989.

    Google Scholar 

  • Spittle B: Paternalistic interventions with the gravely disabled. Aust NZ J Psychiatry 26:107–110, 1992.

    Article  Google Scholar 

  • Starfield B, Wray C, Hess K, Gross R, Birk PS, D’Lugoff BC: The influence of patient-practitioner agreement on outcome of care. Am J Public Health 71:127–131, 1981.

    Google Scholar 

  • Stein HF, Apprey M: Clinical Stories and Their Translations. Charlottesville, University of Virginia Press, 1990.

    Google Scholar 

  • Stewart MA, McWhinney IR, Buck CW: The doctor/patient relationship and its effect upon outcome. J R Coll Gen Pract 29:77–82, 1979.

    Google Scholar 

  • Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR: Patient-Centered Medicine: Transforming the Clinical Method. Thousand Oaks, Calif, Sage Publications, Inc, 1995.

    Google Scholar 

  • Stoeckle JD, Barsky AJ: Attributions: Uses of social science knowledge in the ‘doctoring’ of primary care, in Eisenberg L, Kleinman A (eds): The Relevance of Social Science for Medicine. Dordrecht, Reidel, 1981, pp 223–240.

    Google Scholar 

  • Suchman AL, Matthews DA: What makes the patient-doctor relationship therapeutic? Exploring the connexional dimension of medical care. Ann Intern Med 108(1):125–130, 1988.

    Google Scholar 

  • Suchman AL, Markakis K, Beckman HB, Frankel R: A model of empathic communication in the medical interview. JAMA 277:678–682, 1997.

    Article  Google Scholar 

  • Szasz TS, Hollender MH: The basic models of the doctor-patient relationship. Arch Intern Med 97:585–592, 1956.

    Google Scholar 

  • Todd KH, Samaroo N, Hoffman JR: Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA 269:1537–1539, 1993.

    Article  Google Scholar 

  • Tolstoy L: The Death of Ivan Illyich. Toronto, Bantam Books Inc, 1981.

    Google Scholar 

  • Toombs K: The Experience of Illness. Boston, Kluwer Academic Publishing, 1992.

    Google Scholar 

  • Veatch RM: Models for ethical medicine in a revolutionary age. What physician-patient roles foster the most ethical relationship? Hastings Cent Rep 2:5–7, 1972.

    Google Scholar 

  • Weinberg RB, Mauksch LB: Examining family of origin influences in life at work. J Marital Fam Ther 17(3):233–242, 1991.

    Article  Google Scholar 

  • World Health Organization: World AIDS Day. JAMA 272:1568, 1994.

    Google Scholar 

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Authors
  1. Ronald M. Epstein
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Editors and Affiliations

  1. St. Louis University, St. Louis, Missouri

    Mark B. Mengel M.D., M.P.H.

  2. Baylor College of Medicine, Houston, Texas

    Warren L. Holleman Ph.D.

  3. Oregon Health Sciences University, Portland, Oregon

    Scott A. Fields M.D.

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© 2002 Kluwer Academic Publishers

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Epstein, R.M. (2002). The Patient-Physician Relationship. In: Mengel, M.B., Holleman, W.L., Fields, S.A. (eds) Fundamentals of Clinical Practice. Springer, Boston, MA. https://doi.org/10.1007/0-306-47565-0_19

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  • DOI: https://doi.org/10.1007/0-306-47565-0_19

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-306-46692-2

  • Online ISBN: 978-0-306-47565-8

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