| Titre : | The physician-patient encounter : The physician as a perfect agent for the patient versus the informed treatment decision-making model. (1998) |
| Auteurs : | A. GAFNI ; C. CHARLES ; T. WHELAN ; Department of Clinical Epidemiology and Biostatistics. Centre for Health Economics and Policy Analysis. McMaster University. Hamilton Ontario. CAN ; Department of Clinical Epidemiology and Biostatistics. McMaster University. Hamilton Ontario. CAN ; Supportive Cancer Care Research Unit. McMaster University. Hamilton Ontario. CAN |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 47, n° 3, 1998) |
| Pagination : | 347-354 |
| Langues: | Anglais |
| Mots-clés : | Relation médecin malade ; Relation sociale ; Modèle ; Etude comparée ; Homme |
| Résumé : | [BDSP. Notice produite par INIST R0xb43v6. Diffusion soumise à autorisation]. Assuming a goal of arriving at a treatment decision which is based on the physician's knowledge and the patient's preferences, we discuss the feasibility of implementing two treatment decision-making models : (I) the physician as a perfect agent for the patient, and (2) the informed treatment decision-making models. Both models fall under the rubric of agency models, however, the requirements from the physician and the patient are different. An important distinction between the two models is that in the former the patient delegates authority to her doctor to make medical decisions and thus the challenge is to encourage the physician to find out the patient's preferences. In the latter, the patient retains the authority to make medical decisions and the physician role is that of information transfer. The challenge here is to encourage the physician to transfer the knowledge in a clear and nonbiased way. We argue that the choice of model depends among other things on the ease of implementation (e.g., is it simpler to transfer patient's preferences to doctors or to transfer technical knowledge to patients ?). Also the choice of treatment decision-making model is likely to have an impact on the type of incentives or regulations (i.e., contracts) needed to promote the chosen model. We show that in theory both models result in the same outcome. (...) |
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