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At the opposite end of this spectrum is the Technocratic Approach to risk communication, in which the physician exerts authoritarian control over the patient's treatment and pushes the patient to accept the treatment plan with which they are presented in a paternalistic manner.
In addition, a Canadian physician known as Sir William Osler was known as one of the "Big Four" professors at the time that the Johns Hopkins Hospital was first founded.
Recognizing that patients receive the best care when they work in partnership with doctors, the UK General Medical Council issued guidance for patients "What to expect from your doctor" in April 2013.
and other national Balint societies in other countries.
It is one of the most influential works on the topic of doctor-patient relationships.
The default medical practice for showing respect to patients and their families is for the doctor to be truthful in informing the patient of their health and to be direct in asking for the patient's consent before giving treatment.
Historically in many cultures there has been a shift from paternalism, the view that the "doctor always knows best," to the idea that patients must have a choice in the provision of their care and be given the right to provide informed consent to medical procedures.A patient must have confidence in the competence of their physician and must feel that they can confide in him or her.For most physicians, the establishment of good rapport with a patient is important.Some medical specialties, such as psychiatry and family medicine, emphasize the physician–patient relationship more than others, such as pathology or radiology, which have very little contact with patients.The quality of the patient–physician relationship is important to both parties.The doctor and patient's values and perspectives about disease, life, and time available play a role in building up this relationship.A strong relationship between the doctor and patient will lead to frequent, quality information about the patient's disease and better health care for the patient and their family.for instance, with patients who do not want to know the truth about their condition.Furthermore, there are ethical concerns regarding the use of placebo.Patients who are better educated and from upper or upper middle-class positions generally receive higher quality and quantity of information from physicians than do those toward the other end of the social spectrum, although both sides have an equal desire for information.According to a study of 618 medical encounters between mainly Caucasian physicians and Caucasian and African American patients, physicians perceived African Americans to be less intelligent and educated, less likely to be interested in an active lifestyle, and more likely to have substance abuse problems than Caucasians.