Health Care Analysis

, Volume 9, Issue 4, pp 449–462 | Cite as

Power Issues in the Doctor-Patient Relationship

  • Felicity Goodyear-Smith
  • Stephen Buetow


Power is an inescapable aspect of all socialrelationships, and inherently is neither goodnor evil. Doctors need power to fulfil theirprofessional obligations to multipleconstituencies including patients, thecommunity and themselves. Patients need powerto formulate their values, articulate andachieve health needs, and fulfil theirresponsibilities. However, both parties canuse or misuse power. The ethical effectivenessof a health system is maximised by empoweringdoctors and patients to develop `adult-adult'rather than `adult-child' relationships thatrespect and enable autonomy, accountability,fidelity and humanity. Even in adult-adultrelationships, conflicts and complexitiesarise. Lack of concordance between doctors andpatients can encourage paternalism but may bebest resolved through negotiated care. Afurther area of conflict involves the `doubleagency' of doctors for both patients and thecommunity. Empowerment of all players is notalways possible but is most likely where eachparty considers and acknowledges power issues.

patient-centred care physician-patient relations power (psychology) 


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Copyright information

© Kluwer Academic Publishers 2001

Authors and Affiliations

  • Felicity Goodyear-Smith
    • 1
  • Stephen Buetow
    • 2
  1. 1.Division of General Practice & Primary Health Care, Faculty of Medical & Health SciencesUniversity of AucklandAucklandNew Zealand
  2. 2.Division of General Practice & Primary Health Care, Faculty of Medical & Health SciencesUniversity of AucklandAucklandNew Zealand

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