From Medical Paternalism to Care Partnerships: A Logical Evolution Over Several Decades

  • Vincent Dumez
  • Marie-Pascale PomeyEmail author
Part of the Organizational Behaviour in Healthcare book series (OBHC)


This chapter focuses on the Partnership in Care and Services movement that has progressively emerged in health care since the beginning of the 2000s. In order to fully understand the foundations of this movement, this following will explore the way that this movement has come about within healthcare delivery systems, in health education, research, and community work, in comparison and continuity with a variety of medical models that have evolved over time and led to this significant paradigm shift.


Partnership in care and services Shared decision-making Self-management Therapeutic patient education Medical paternalism Patient and family centered care 


  1. De La Tribonnière, X. 2016. Pratiquer l’éducation thérapeutique: L’équipe et les patients. Paris: Elsevier Masson.Google Scholar
  2. Emanuel, E.J., and L.L. Emanuel. 1992. Four models of the physician-patient relationship. JAMA 267 (16): 2221–2226.CrossRefGoogle Scholar
  3. Flora, L. 2013. Savoirs expérientiels des malades, pratiques collaboratives avec les professionnels de santé: état des lieux. Education permanente 195: 59–72.Google Scholar
  4. Foucault, M. 1988. Technologies of the self. In Technologies of the self: A seminar with Michel Foucault, ed. L. Martin, H. Gutman, P. Hutton, and M. Foucault. Amherst, MA: University of Massachusetts Press.Google Scholar
  5. Gaucher, N., and E. Racine. 2015. Théories de la justice. Dans Payot A. et Janvier A. Éthique clinique: un guide pour aborder la pratique. Montréal; Éditions du CHU Sainte-Justine 75–86.Google Scholar
  6. Held, V. 2006. The ethics of care: Personal, political, and global. Oxford: Oxford University Press.Google Scholar
  7. Jouet, E., L. Flora, and O. Las Vergnas. 2010. Construction et reconnaissance des savoirs expérientiels des patients. Pratiques de Formation-Analyses 58–59: 13–94.Google Scholar
  8. Karazivan, P., V. Dumez, L. Flora, M.-P. Pomey, C. Del Grande, D.P. Ghadiri, N. Fernandez, E. Jouet, O. Las Vergnas, and P. Lebel. 2015. The patient-as-partner approach in health care: A conceptual framework for a necessary transition. Academic Medicine 90 (4): 437–441.CrossRefGoogle Scholar
  9. Legare, F., S. Turcotte, D. Stacey, S. Ratte, J. Kryworuchko, and I.D. Graham. 2012. Patients’ perceptions of sharing in decisions: A systematic review of interventions to enhance shared decision making in routine clinical practice. Patient 5 (1): 1–19.CrossRefGoogle Scholar
  10. Lorig, K.R., and H. Holman. 2003. Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine 26 (1): 1–7.CrossRefGoogle Scholar
  11. Pomey, M.P., L. Flora, P. Karazivan, V. Dumez, P. Lebel, M.-C. Vanier, B. Desbarges, N. Clavel, and E. Jouet. 2015. Le “Montreal Model”: enjeux du partenariat relationnel entre patients et professionnels de la santé. Santé Publique HS (S1): 41–50.CrossRefGoogle Scholar
  12. Rathert, C., M.D. Wyrwich, and S.A. Boren. 2013. Patient-centered care and outcomes: A systematic review of the literature. Medical Care Research and Review 70 (4): 351–379.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.Faculty of MedicineUniversity of MontrealMontrealCanada
  2. 2.School of Public HealthUniversity of MontrealMontrealCanada

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