Waris Qidwai.
Paternalistic model of medical practice.
J Coll Physicians Surg Pak Jan ;13(5):296.

In the `Physician-focused` model, a physician is a fatherly figure who decides what is in the best interest of the patient, that is why it is also called the `paternalistic model of practice`. In such a model of practice, patient is just a passive recipient of all the decisions of the physician. We have, on the other hand, a `patient-focused` model of practice, in which patient is involved in the decisions made in his/her interest during medical care. In such a model of practice, patient`s autonomy is considered of paramount importance. Debate is ongoing as to which is the best model of practice? It is recommended that physicians adopt a more flexible approach in decision-making, keeping patient`s preferences in mind

USER COMMENTS

The focus of reimbursement in medicine is set to change, the ‘fee for service’ mode will be replaced by one that focuses less on the procedure and more on the evidence behind it. There will be a greater emphasis on demonstrable benefits and/or harms of recommended treatment and will include; a consideration of critical appraisal of evidence, cost-benefit analysis, guideline appraisal, ‘shared risk’ and statistical quality improvement analysis. Justification for specific medical care will have to be supported by substantive evidence of its efficacy and cost effectiveness: the risk/benefit and cost/benefit models. Decision making will no longer be the prerogative of administrator or clinician. Evidence will be ‘king’, the patient will move from passive to active role and will, like any other ‘customer’ demand decision making information based on all the evidence available. The future of medicine will be part of a challenge of individualizing care based on best evidence, clinical judgment and user preferences.
Posted by: zbysfedo on Jun 2003

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