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Governance mechanisms in the physician–patient relationship: a literature review and conceptual framework

机译:医患关系中的治理机制:文献综述和概念框架

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Background The physician–patient relationship is a critical component of the integrated approach to excellence in health‐care delivery. Although commonly modelled within the boundaries of the agency theory and regarded as synonymous to an agent–principal interaction, there exists only a sparse understanding about the most effective ways of governing it. Objective This article undertakes a selective review of the growing body of research on the governance of the physician–patient relationship to discuss the current state of the knowledge in the field and suggest promising avenues for further exploration. Findings On the basis of an extensive analysis of the relevant literature, we identify two emerging streams of inquiry on the trust‐based (i.e. trust and ethical oversight) and distrust‐based (i.e. patient information‐empowerment and decision‐making authority) governance mechanisms of the physician–patient relationship and discuss the key findings within each stream. Discussion To conciliate the on‐going scholarly debate concerning the efficacy of trust‐ and distrust‐based mechanisms, we draw the foundations of a conceptual framework which might serve as a guide for more integrative research endeavours on the governance of the physician–patient relationship.
机译:背景技术医患关系是实现卓越医疗保健的综合方法的关键组成部分。尽管通常是在代理理论的范围内建模的,并且被视为代理人与主体互动的代名词,但对于管理它的最有效方式只有很少的理解。目的本文对日益增长的对医患关系治理的研究进行了回顾,以讨论该领域知识的现状,并为进一步探索提供了有希望的途径。调查结果在对相关文献的广泛分析的基础上,我们确定了基于信任(即信任和道德监督)和基于不信任(即患者信息赋权和决策权)治理机制的两种新兴查询流。医患关系,并讨论每个流程中的关键发现。讨论为了使正在进行的有关基于信任和基于不信任机制的有效性的学术辩论得到调和,我们绘制了概念框架的基础,该框架可作为对医患关系治理的更多综合研究工作的指南。

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