The centrality of patient-physician relationship to medical professionalism: an ethical evaluation of some contemporary models.

Because a physician’s primary professional obligation is to promote the welfare of the patients directly under his or her care, the patient-physician relationship (PPR) is the irreplaceable cornerstone of medical practice. A PPR is formed when a patient seeks medical help and a physician responds by providing medical service, including giving an opinion, making a diagnosis, or treating the patient. Each PPR is unique, depending on the context, purpose, and function of each patient-physician encounter and the specific expectations of all parties involved. These aspects vary from one culture to another, and change over time. Hence, different models of the PPR reflect the wide spectrum of clinical encounters that are established in dissimilar situations and at different times. No one model is always appropriate, but for daily medical practice, one model that works better than others can usually be identified. Since PPR models are ethically evaluated and justified by normative standards, the ideal PPR model preferred by a community also reflects that community’s moral values. As such, PPR models are dynamic, culturally sensitive, and not easily universalised.