Provider-consumer relationship

1. Meaning and significance of
Interpersonal relationship
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2. Unit 5: Interpersonal Relationship (Provider-
Consumer/user Relationship) 3 Hours
• Meaning and significance of inter-personal/provider-
consumer/user relationship
• Talcott parsons model of the doctor – patient relationships
applied to public health
• The Szasz – Hollander model applied to public health
• Communication pattern between professional and indigenous
health care practices
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3. Inter-personal/provider-
consumer/user relationship
• An interpersonal relationship is a relatively long-term or short
term association between two or more people.
• This association may be based on regular business interactions, or
provider consumer relationship for health services.
• Interpersonal relationships take place in a great variety of
contexts, such as family, friends, marriage, social work, and
neighborhoods.
• They may be regulated by law, custom, or mutual agreement, and
are the basis of social groups and society as a whole.
• Although humans are fundamentally social creatures,
interpersonal relationships are not always healthy.
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4. Three success elements in
Relationships
It takes a combination of:
1. Self-awareness,
2. Self confidence,
3. Communication skills
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5. Self-awareness
•Becoming self-aware is the first step to improving our
interpersonal effectiveness.
•Through self-awareness we learn what impact our
behaviours - both positive and negative - have on others.
•That knowledge helps us become more effective in our
interactions with others.
•Once we become self-aware we can examine and change
behaviours that need changing.
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6. Self-Confidence
•Sureness about one’s
self-worth and
capabilities
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7. Communication skills
• Interpersonal communication mean the ability to relate to people
in written as well as verbal communication.
• Occurs in both one-on-one and in a group setting.
• This also means being able to handle different people in different
situations, and making people feel at ease.
• Active listening,
• Giving and receiving criticism,
• Dealing with different personality types, and
• Nonverbal communication.
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8. What are Interpersonal Skills?
• A set of behaviours which allow us to communicate effectively and
unambiguously in a face-to-face setting.
• They can also be thought of as behaviours which assist progress
towards achieving an objective.
• Interpersonal relationship skills help us to relate in positive ways
with our family members, colleagues and others.
• This may mean being able to make and keep friendly relationships
as well as being able to end relationships constructively.
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9. Six interpersonal skills
There are just six interpersonal skills which form a process that is applicable to
all situations:
1. Analyzing the situation
2. Establishing a realistic objective
3. Selecting appropriate ways of behaving
4. Controlling your behaviour
5. Shaping other people's behaviour
6. Monitoring our own and others' behaviour
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10. Applicability of Interpersonal Skills
•Analyzing the situation helps us to set realistic
objectives
•Establishing objectives, in turn, provides the context in
which to make choices about how best to behave
•By being conscious of our own behaviour in working
towards the achievement of objectives we are more
likely to influence other people’s behaviour
•Constant monitoring will provide the feedback we need
to make situation-dependent adjustments.
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11. Interpersonal Communication skills
• A respectful tone of voice conveys that you are taking others seriously
and that you also expect to be taken seriously.
• Eye contact - is vital for good communication.
• Appropriate body language encourages conversation.
• Clear, organized ideas help us accurately and honestly describe our
feelings and contribute to conversations and decisions that need to be
made.
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12. Significance of Interpersonal relationship
• Sensitizes the individuals about the tasks and activities in his group
life.
• Places the individuals in a certain situation and implies certain
prescribed actions.
• Give other clues about how he wants to behave and expects the other
persons to behave.
• Helps to know the others ideas and methods about the situations.
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13. Talcott parsons model of the doctor – patient
relationships applied to public health
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14. Talcott parson’s model of the doctor-
patient relationship
The premises (statement of which reasoning is based) of the
parsonian model include the following:
• The problem of health is “intimately involved and the functional
prerequisites of the social system”. Too low a general level of health,
too high an incidence of illness, is dysfunctional.
• Health care is a social role and relationship between a helping agent
and a person needing help.
• The social roles of the health care relationship are a patterned sector
of culture and this learned sequences of behaviour.
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15. Doctor-patient system model
Status Patient’s (sick) role Doctor’s (professional) role
Obligations:
(Duty)
To be motivated to get well Act for the welfare of the patient
To seek technically
competent help
Be guided by the rules of
professional behaviour
To trust the doctor, or to
accept the competence gap
Be objective in emotionally
detached
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16. Criticism:
• Lack of uniformity in illness response among various persons and
social groups.
• It applies to acute illness which are temporary conditions.
• Less applicability for chronic illness such as cancer, heart disease.
• It is based on traditional one to one interaction, it can not be
applied to a group of individuals.
• Middle class oriented-lay people do homework, they do not obey
the suggestions of not doing extra works.
• This model is deficient to apply for mental illness.
• Doctor-patient relations is more complex and is reciprocal.
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17. Szasz-Hollander Model: Behaviour
implication of organic symptoms
• Szasz and Hollander, both by physicians, saw more
extensive behavioural implications (a possible effect or
result of an action or a decision) of symptoms which they
incorporated in a modes of Doctor-patient relationships
based on a threefold typology.
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18. Model Physician’s
role
Patient’s role Clinical
application
Prototype
(original
example) of
model
Activity
passivity
Does
something for
patient
Recipient (unable to
respond or inert)
Anaesthesia,
acute trauma
Patient-infant
Guidance
cooperatio
n
Tells patient
what to do
Co-operator (obeys) Acute infectious
processes
Parent-child
(adolescent)
Mutual
participatio
n
Helps patient
to help himself
Participant in
“partnership” (uses
expert help)
Most chronic
illness, psycho
analysis, etc.
Adult-adult
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19. 1. Activity-passivity:
• Physician is active and the patient is passive.
• Due to the emergencies the patient is more or less completely
helpless and the physician does something or everything to him.
• Treatment takes place regardless of the patient’s contribution.
• The relationship of the doctor to the patient is similar to that of the
parent to the helpless infant.
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20. 2.Guidance-cooperation:
• It applies to most acute disorders and especially to these of an
infectious type.
• Although the patient is ill, he is still keenly aware of what is going
on, and he is capable of following directions and of exercising
some judgment.
• This model has its prototype in the relationship of the parent and
his child (or adolescent).
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21. 3. Mutual participation:
•This is useful for the management of chronic illness in
which the treatment programme is carried out by the
patient with only occasional consultation with a physician
(i.e. diabetes mellitus, hypertension, etc.)
•According to this model, the physician helps the patient
to help himself.
•Its prototype is the relationship of adult to adult with one
having specialized knowledge that other needs.
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22. Criticism
• Hospital based
• One to one person relation
• Mention of especially for acute illness
• Deficient with mental and chronic illness, middle class oriented
• Curative aspects and
• Lacks to explain community approach
• Not only medicines or other drugs help for the recovery of illness,
disease and problems but behaviour of health care provider also plays
vital role for making healthy and to cure the consumer or user or
patient.
• It is seen in various parts of the health care delivery settings that
prescribes or health care providers have negatively behaviour in this
situation have seen very rough.
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23. Communication pattern between professional
and indigenous health care practices
Sn Professional Indigenous
1 Registration system (outdoor) Personal contact
2 Institutional system Family-individual system
3 Written documents Verbal fixation
4 Strict on date and time Flexibility on date and time
5 Lab/supporting alternatives Sacrifice system
6 Technical methods of using
instruments
Approximation based on healers decisions
7 More responsible and easy to
predict
No any responsibility and haphazard
prediction
8 Routine for follow up No such system but frequent visit
9 Patient comes to hospital Professional healer goes to the patients house
10 Long term relationships and
short term relationships
Long term relationships with family system
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24. Barriers in effective professional-patient
relationship:
• Lack of knowledge about the medical system
• Illiteracy, insufficient health resources
• Professional centrist, superior inferior feelings
• Lack of socio-cultural, economic knowledge and psychological barrier
• Health duty of the professional and misunderstanding
• Socio-political and other pressures rule of violence, money centred
behaviour of the providers
• Lack of budget in organisations, lack of beds, medicines, equipment,
• Poverty of the patient and country
• Personality clash between professionals themselves and between providers-
users, users-administrators, providers administrators, inter and extra
environment.
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