Approach to the Patient

  • Harriet A. Squier
  • Howard Brody
  • Barbara Supanich


The patient-centered family physician deals with patient problems in the context of the whole person: life history, personal issues, family, physical surroundings. With a disease-oriented approach the physician deals only with the disease process, exerting authority over the patient to control abnormal biomedical processes. In contrast, the patient-centered physician addresses the disease process, the patient’s illness experience, and the overall psychological and social contexts. This physician works with the patient to set priorities and determine each participant’s role in management.1 This approach empowers the patient, improves healing, develops an ongoing therapeutic relationship, and enlists other appropriate resources and personnel in an overall management plan. The patient-centered method promotes a “sustained partnership”2 that continues over time to manage the patient’s medical problems. By incorporating discussion about and understanding of the patient’s family system into the interaction, the patient-centered physician automatically practices family-centered care.


Psychosocial Issue Breast Pain Biomedical Problem Resident Behavior Manage Care Setting 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Stewart M, Brown JB, Weston WW, et al. Patient-centered medicine: transforming the clinical method. Thousand Oaks, CA: Sage, 1995.Google Scholar
  2. 2.
    Leopold N, Cooper J, Clancy C. Sustained partnership in primary care. J Fam Pract 1996;42:129–37.PubMedGoogle Scholar
  3. 3.
    Maheux B, Dufort F, Beland F, Jacques A, Levesque A. Female medical practitioners: more preventive and patient oriented? Med Care 1990;26:87–92.CrossRefGoogle Scholar
  4. 4.
    Kaplan SH, Greenfield S, Ware JE. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care 1989;27:S110–27.PubMedCrossRefGoogle Scholar
  5. 5.
    Thomas KB. General practice consultations: is there any point in being positive? BMJ 1987;294:1200–2.PubMedCrossRefGoogle Scholar
  6. 6.
    Rinaldi RC. Positive effects of psychosocial interventions on total health care: a review of the literature. Fam Syst Med 1985;3:417–26.CrossRefGoogle Scholar
  7. 7.
    Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977;196:129–36.PubMedCrossRefGoogle Scholar
  8. 8.
    Lazare A. Shame and humiliation in the medical encounter. Arch Intern Med 1987;147:1653–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Barsky AJ. Hidden reasons some patients visit doctors. Ann Intern Med 1981;94:492–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Kleinman A, Eisenberg L, Good B. Culture, illness and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med 1978;88:251–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Klein D, Najman J, Kohrman A, Munro C. Patient characteristics that elicit negative responses from family physicians. J Fam Pract 1982;14:881–8.PubMedGoogle Scholar
  12. 12.
    Gorlin R, Zucker HD. Physicians’ reactions to patients: a key to teaching humanistic medicine. N Engl J Med 1983;308: 1059–63.PubMedCrossRefGoogle Scholar
  13. 13.
    Lang F. Resident behaviors during observed pelvic examinations. Fam Med 1990;20:153–5.Google Scholar
  14. 14.
    Bergh KD. Time use and physicians’ exploration of the reason for the office visit. Fam Med 1996;28:264–70.PubMedGoogle Scholar
  15. 15.
    Conrad P. The noncompliant patient in search of autonomy. Hastings Cent Rep 1987;Aug:15–17.Google Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Harriet A. Squier
  • Howard Brody
  • Barbara Supanich

There are no affiliations available

Personalised recommendations