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This communication model places the physician in a position of omniscience and omnipotence over the patient and leaves little room for patient contribution to a treatment plan.
Most universities teach students from the beginning, even before they set foot in hospitals, to maintain a professional rapport with patients, uphold patients' dignity, and respect their privacy.
A patient must have confidence in the competence of their physician and must feel that they can confide in him or her.
In these circumstances and also in cases where there is genuine divergence of medical opinions, a second opinion from another physician may be sought or the patient may choose to go to another physician.
Additionally, the benefits of any placebo effect are also based upon the patient's subjective assessment (conscious or unconscious) of the physician's credibility.
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.Michael and Enid Balint together pioneered the study of the physician patient relationship in the UK.Michael Balint's "The Doctor, His Patient and the Illness" (1957) outlined several case histories in detail and became a seminal text.Does giving a sugar pill lead to an undermining of trust between doctor and patient?Is deceiving a patient for his or her own good compatible with a respectful and consent-based doctor–patient relationship?The default medical practice for showing respect to patients 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.