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EDUCATION AND DEBATE: Cathy Charles, Tim Whelan, and Amiram Gafni What do we mean by partnership in making decisions about treatment? BMJ 1999; 319: 780-782 [Full text]

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A fourth model

Sydney Morss   (16 February 2000)

Re: A fourth model

Ravindra Ruberu   (26 December 2008)

A fourth model 16 February 2000
Sydney Morss, Robert Wood Johnson Clinical Scholar Johns Hopkins Hospital Send response to journal: Re: A fourth model	In this age of increasing marketing by pharmaceutical companies and healthcare organizations and increased patient advocacy, I would consider adding a fourth model to your theoretical framework. Here, the direction is one way, from the patient to the doctor; the physician acquiesces to a patient request without much discussion or deliberation on his or her part. Pressure from patients or responding to patient expectations has been shown to be an important factor in decisions such as providing antibiotics or other prescriptions and in referring to specialty care.
Re: A fourth model 26 December 2008
Ravindra Ruberu, Specialist in ORL and consultant surgeon National Hospital Colombo Sri Lanka Send response to journal: Re: Re: A fourth model	I do not think that a separate fourth model exists. It is most unlikely that a doctor will respond to a patients request without any deliberation of the factors concerned in the management. It is more an extreme end of the Informed model where the doctor gives in to the patients requests without suggesting any modifications. Competing interests: None declared