Practitioner or Patient - Who's in Charge?

Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)

“…The value of information about treatment alternatives, and their risks and benefits for the patient, is less well understood (Haug and Lavin, 1981;Beisecker and Beisecker, 1990;Ryan, 1992). As noted earlier, studies indicate that many patients have high preferences for information about their illness and its management but do not engage in information seeking behaviours or in treatment decision-making.…”

Patient-Nurse Collaboration in Nursing Practice: A Korean Study

“…A shift from the professionals-patients relationships of authority and dependence to that of equality and mutuality has been most clearly demonstrated in patientphysician relationships and in the context of medical care (Haug & Lavin, 1981;Lavin, Haug, Belgrave, and Breslau, 1987;Blanchard, Labrecque, Ruckde-schel, & Blanchard, 1988).…”

“…But the process through which a collaborative form of provider-patient alliance is established is not well specified in the literature. Kim et al (1993) tested the kim's theoretical path structural model developed from combining theoretical ideas of the power paradigm adopted by Haug and Lavin (1981) in which personal characteristics that affect obedience to authority are considered the key factors leading to consumerism and the structuralist paradigm (Merton, 1968) in which beliefs and the attitudes are viewed to be affected by social structural elements such as cultural and institutional value structures (Figure 1). Within that model, attitudes in consumerism are identified at three levels of general consumerist attitudes, health-care consumerist attitudes, and nursing-care collaborative attitudes.…”

“…Kim (1983) suggests that the level of collaboration in nursing care decision-making is influenced by the attitudes and beliefs in which participants bring into the situation and by the nature of the situation in which decisions are made. Haug and Lavin (1981) also suggest that both "the consumerist model" and the sick-role model" may be viable forms of the consultation process in which the attitudinal orientations of physician and patients are the key factors influencing "the dynamics of who's in charge." Hence, the general as well as more specific attitudes regarding health-care consumerism and collaboration held by the public and professionals can be considered the foundation upon which different types of negotiations and interactions emerge in actual encounters between a profession and a patient.…”

Physicians Providing Alternative Medicine Boundary Crossing and the Emergence of Integrative Medicine

“…However, these financial flows have by-passed the mainstream system. Medicine, as the most autonomous of professions, still sensitively reacts to economic incentives (Haug & Sussman, 1969;Haug & Lavin, 1981;Mechanic, 1979:181;The New York Times, 1990;Sullivan, 1993). This has raised alarm from within the system, with charges that the public's foolhardy purchases encourage unproven practices (cf.…”