This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (78)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Forging a New Model of the Patient-Physician Relationship

John Balint, MD, FRCP; Wayne Shelton, PhD, MSW

JAMA. 1996;275(11):887-891.

Abstract
The patient-physician relationship has undergone major and increasingly rapid changes in the past 40 years. It has moved from a relationship based on physician paternalism, through one of patient autonomy, to one where the patient and the physician's authority and control over the patient's care are facing significant threats from outside sources. In this article, we examine the historical and social forces that have contributed to these changes and the effects these forces have had on the traditional models of the patient-physician relationship. We present arguments to support our proposal for a patient-physician alliance in the community based on mutual education of physician and patient about health and illness, values and persons, social responsibility, beneficence, trust, and a degree of paternalism. We believe such an alliance offers the best hope for patients and their physicians to regain the initiative in guiding the evolution of health care in a way that preserves the essentials of the therapeutic relationship.

(JAMA. 1996;275:887-891)

Author Affiliations
From the Center for Medical Ethics, Education, and Research, Department of Medicine, Albany (NY) Medical College.

Footnotes
Reprint requests to the Center for Medical Ethics, Education, and Research, Department of Medicine, Albany Medical College, Albany, NY 12208 (Dr Balint).

The Patient-Physician Relationship section editor: Richard M. Glass, MD, Deputy Editor, JAMA.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Risk Information Exposure and Direct-to-Consumer Genetic Testing for BRCA Mutations among Women with a Personal or Family History of Breast or Ovarian Cancer
Gray et al.
Cancer Epidemiol. Biomarkers Prev. 2009;18:1303-1311.
ABSTRACT | FULL TEXT  

The Physician-Surrogate Relationship
Torke et al.
Arch Intern Med 2007;167:1117-1121.
ABSTRACT | FULL TEXT  

Role dilemmas among health-workers in cross-cultural patient encounters around dietary advice
Fagerli et al.
Scand J Public Health 2005;33:360-369.
ABSTRACT  

First Patient-Centered Drug Information Service in Germany--A Descriptive Study
Maywald et al.
The Annals of Pharmacotherapy 2004;38:2154-2159.
ABSTRACT | FULL TEXT  

Patient and Physician Attitudes to Using Medications with Religiously Forbidden Ingredients
Sattar et al.
The Annals of Pharmacotherapy 2004;38:1830-1835.
ABSTRACT | FULL TEXT  

Physician-Patient Relationship and Medication Compliance: A Primary Care Investigation
Kerse et al.
Ann Fam Med 2004;2:455-461.
ABSTRACT | FULL TEXT  

Inert Medication Ingredients Causing Nonadherence Due to Religious Beliefs
Sattar et al.
The Annals of Pharmacotherapy 2004;38:621-624.
ABSTRACT | FULL TEXT  

African American Patients' Perspectives on Medical Decision Making
Torke et al.
Arch Intern Med 2004;164:525-530.
ABSTRACT | FULL TEXT  

Acceptability of oesophagogastroduodenoscopy without intravenous sedation: patients' versus endoscopist's perception with special reference to older patients
Thanvi et al.
Postgrad. Med. J. 2003;79:650-651.
ABSTRACT | FULL TEXT  

Do Physicians Not Offer Useful Services Because Of Coverage Restrictions?
Wynia et al.
Health Aff (Millwood) 2003;22:190-197.
ABSTRACT | FULL TEXT  

Engaging patients in medical decision making
Kravitz and Melnikow
BMJ 2001;323:584-585.
FULL TEXT  

Racial and Ethnic Disparities in Perceptions of Physician Style and Trust
Doescher et al.
Arch Fam Med 2000;9:1156-1163.
ABSTRACT | FULL TEXT  

Is the Therapeutic Nature of the Patient-Physician Relationship Being Undermined?: A Primary Care Physician's Perspective
Branch
Arch Intern Med 2000;160:2257-2260.
FULL TEXT  

Examining consent within the patient-doctor relationship
Habiba
J. Med. Ethics 2000;26:183-187.
ABSTRACT | FULL TEXT  

Informing Patients: A Guide for Providing Patient Health Information
Tang and Newcomb
J. Am. Med. Inform. Assoc. 1998;5:563-570.
ABSTRACT | FULL TEXT  

Informing Patients: A Guide for Providing Patient Health Information
Tang and Newcomb
J Am Med Inform Assoc 1998;5:563-570.
ABSTRACT | FULL TEXT  

Clinicians' and Seniors' Views of Reference- Based Pricing: Two Sides of a Coin
Mullett and Coughlan
Journal of Applied Gerontology 1998;17:296-317.
ABSTRACT  

Effects of Managed Care on Physician-Patient Relationships, Quality of Care, and the Ethical Practice of Medicine: A Physician Survey
Feldman et al.
Arch Intern Med 1998;158:1626-1632.
ABSTRACT | FULL TEXT  

Ethics and Micromanaged Care
Brodell
Arch Dermatol 1996;132:1013-1015.
ABSTRACT  

The Patient-Physician Relationship: Time to Reimburse What We Preach
Hensel
JAMA 1996;276:27-27.
ABSTRACT  

Comparing needs with available resources: a study of the use of drug information by rheumatology patients
Farmer and Peffer
Journal of Librarianship and Information Science 1996;28:227-239.
ABSTRACT