Protagonist-patient and servant-doctor: A medicine for the sick doctor-patient relationship

Abstract

The doctor-patient relationship (DPR) is very ill; it is in need of emergency assistance. Although there have been change in this relationship, no current model is satisfying. In 1972, Robert Veatch defined some models of DPR. Likewise, Pierloot, in 1983, and Balint, in 1975 and ultimately, Mead and Bower, 2000 with the model of Person-center-care (PCC) medicine.ObjectiveEvaluate the different kinds of DPR described in the literature and propose an abduction-based model of the Servant DPR, in which patients are protagonists in their treatment.MethodsPubmed literature review of the last forty years with the keyword ‘physician-patient relations’.DiscussionWhile nursing care advanced in its professional efficacy through Watson's human care and through the leader servant model, the DPR models demonstrated that the doctors are lost in their posture, even feeling as abused heroes. Models that include the patient in decision-making and that value the patient as a person (PCC) promise a revolution in the medical realm. Nevertheless, the PCC model is not enough to heal the DPR itself, because the role of the doctor must be changed to adapt to the relationship, otherwise, the PCC by itself can increase the burden upon the doctor. Doctors with a role of remunerated servant (not slave), like any other professional who delivers a service with excellence, focusing in the main actor, the patient, can heal the DPR.ConclusionThe Servant DPR gives a positive counter transference, increasing the doctor's motivation and giving him back the sense of purpose in medicine, increasing the health system's effectiveness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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