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Patient-centred and Doctor-centred Models of Clinical Decision-making

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Decision-Making in General Practice
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Abstract

When I was given this title, my first thought was: “How many models of clinical decision-making are there?” At first sight, there appear to be many, but further reflection convinces me that many of them are variations on the same theme. My thesis will be that there are only two basic models, which I have called patient-centred and doctor-centred.

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References

  • Balint, M., Hunt, J., Joyce, D., Marinker, M., and Woodcock, J., (1970): Treatment or Diagnosis: A Study of Repeat Prescriptions in General Practice. J. B. Lippincott Company, Toronto.

    Google Scholar 

  • Barrows, H.S., Norman, G.R., Neufeld, V.R., and Feightner, J.W. (1982): The Clinical Reasoning of Randomly Selected Physicians in General Medical Practice. Clinical and Investigative Medicine, 5, 1, 49–55.

    PubMed  CAS  Google Scholar 

  • Bernstein, B., (1971): Class, Codes and Control. London, Routledge and Kegan Paul.

    Book  Google Scholar 

  • Brooke, J.B., & Sheldon, M.G., (1985): Decision = Patient with Problem + Doctor with Problem. This volume.

    Google Scholar 

  • Brooke, J.B., Rector, A., and Sheldon, M.G., (1984): A Review of Studies of Decision-Making in General Practice. Medical Informatics, 9, 45–53.

    Article  PubMed  CAS  Google Scholar 

  • Bruner, J.S., Goodnow, J.J., and Austin, G.A. (1956): A Study of Thinking. New York, John Wiley.

    Google Scholar 

  • Burztajn, H., Feinbloom, R.I., Hamm, R.M., and Brodsky, A., (1981): Medical Choices, Medical Chances. New York, Delacorte Press/Seymour Lawrence.

    Google Scholar 

  • Byrne, P.S., and Long, B.E.L., (1976): Doctors Talking to Patients. H.M. Stationery Office.

    Google Scholar 

  • Carmichael, L., and Carmichael, J., (1982): The Relational Model in Family Practice. Marriage and Family Review 4, 123–133.

    Article  Google Scholar 

  • Crombie, D.C., (1963): Diagnostic Methods. The Practitioner, 191, 539.

    PubMed  CAS  Google Scholar 

  • Crookshank F.G., (1926): The Theory of Diagnosis. Lancet, ii, 939–942, 995–999.

    Google Scholar 

  • Elstein, A.S., Shulman, L.S., and Sprafka, S.A., (1978): Medical Problem-Solving. An Analysis of Clinical Reasoning. Cambridge, Harvard University Press.

    Google Scholar 

  • Gale, J., and Marsden, P., (1985): Diagnosis: Process not Product. This publication.

    Google Scholar 

  • Gombrich, E.H., (1960): Art and Illusion. Princeton University Press.

    Google Scholar 

  • Gregory, R., in Miller, J., (1983): States of Mind. British Broadcasting Corporation.

    Google Scholar 

  • Hall, E.T., (1976): Beyond Culture. New York, Doubleday and Co.

    Google Scholar 

  • Howie, J.G.R., (1972): Diagnosis — the Achilles Heel? Journal of the Royal College of General Practitioners, 22, 241–258.

    Google Scholar 

  • Kleinmuntz, B., (1968): The Processing of Clinical Information by Man and Machine. In Formal Representation of Human Judgement. B. Kleinmuntz, ed. New York, John Wiley.

    Google Scholar 

  • Levenstein, J.H., McCracken, E., Stewart, M., Brown, J., and McWhinney, I.R., (1983): A Model for the Office Visit in Family Medicine. Unpublished paper, The University of Western Ontario.

    Google Scholar 

  • McWhinney, I.R., (1981): An Introduction to Family Medicine. New York, Oxford University Press.

    Google Scholar 

  • Rogers, C., (1951): Client-Centred Therapy. Cambridge, Mass. Riverside Press.

    Google Scholar 

  • Smith, D.H., and McWhinney, I.R., (1975): Comparison of the Diagnostic Methods of Family Physicians and Internists. Journal of Medical Education, 50, 264–270.

    PubMed  CAS  Google Scholar 

  • Stevens, J., (1974): Brief Encounter. Journal of the Royal College of General Practitioners, 24, 5–22.

    PubMed Central  Google Scholar 

  • Stewart, M.A., (1983): What is a Successful Doctor-Patient Interview — A Study of Interactions and Outcomes. Social Science and Medicine, in press.

    Google Scholar 

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© 1985 Ian R. McWhinney

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McWhinney, I.R. (1985). Patient-centred and Doctor-centred Models of Clinical Decision-making. In: Sheldon, M., Brooke, J., Rector, A. (eds) Decision-Making in General Practice. Palgrave, London. https://doi.org/10.1007/978-1-349-07159-3_4

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  • DOI: https://doi.org/10.1007/978-1-349-07159-3_4

  • Publisher Name: Palgrave, London

  • Print ISBN: 978-1-349-07161-6

  • Online ISBN: 978-1-349-07159-3

  • eBook Packages: MedicineMedicine (R0)

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