Models of the physician-patient relationship

Abstract

To the Editor. —Because we are always interested in concise, carefully trimmed conceptualizations of complex phenomena, we read with interest "Four Models of the Physician-Patient Relationship" by Emanuel and Emanuel. 1 While the article does manage to clearly characterize four models of the physician-patient relationship and argue "descriptively and prescriptively" in favor of one "ideal" relationship—the deliberative model—we feel that the pigeonholing of idealized approaches to patient care confuses rather than simplifies the whole matter. It is not wise to adopt any single model "as the shared, paradigmatic reference" of the physician-patient relationship. What strikes us as the most important and the most delicate and elusive aspect of the physician-patient relationship is the physician's potential ability to assimilate into the treatment of disease the diverse and changing desires of patients, allowing for moods, phases, growth, and idiosyncracies. While we don't believe in the concept of an ideal physician, we think