Content uploaded by Massimo Di Rienzo
Author content
All content in this area was uploaded by Massimo Di Rienzo on Apr 04, 2022
Content may be subject to copyright.
!"#$ #% &
'()* +(++
*$,%
-./0/--/.//--/1
Characteristics of a doctor–patient
relationship
) $
-2**02
0-0-
#$
,#
03-0
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(4#$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
/0
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
) $
-2**02
$$ 5
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
) $
-2**02
$$ 5
•/ 6 7 88
$ #89::
) $
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
0-0-
#$
#5
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
0-0-
#$
#5
• #) $$
"# ; #
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
# 8 95
•-$ #)) $ #
;"9<$<#
,#
03-0
/
'$#'"#(2(&
3/4
•&-%&$%#'
*#-$,#'##'##%
#'#"-
•&-%'',#"-5(risk
events6#'-#7"#$-'*
0=0213
/*0/-2**0- /10/0-0-
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
/
/* ->?0 -/3/->
3, 9))#$;
$)) $ ,/0/@00
/30/ "9)) 9
)
$< ,/0/
-0
#" 9$)
9 ) !#
) "!
)
,/0/
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
•#) $$$
9;, $$ 9$%
$$ "99)9##
A9 * $9 #
2$%-%##(
#'*"&#'#
9#&"$$%"%
*/1.,
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
•#) $$$
9;, $$ 9$%
$$ "99)9##
A9 * $9 #
*/1.,
/* ->?0 -/3/->
3, 9))#$;$)
) $ ,/0/@00
/30/ "9)) 9
)$< ,/0/
-0 #" 9$) 9
) !# )
"!) ,/0/
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
•#* $9 ) $
$$ 9; $$ 9
"# ;
*/1.,5
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
•#* $9 ) $
$$ 9; $$ 9
"# ;
*/1.,5
/* ->?0 -/3/->
3, 9))#$;$)
) $ ,/0/@00
/30/ "9)) 9
)$< ,/0/
-0 #" 9$) 9
) !# )
"!) ,/0/
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
•#* $9 ) $
$$ 9; $$ 9
"# ;
/:
*/1.,5
renis pigmentosa
! "#$% &##'"#%('"#"#
%#"(#'1'$$#)'*"+&'#'
*"'*"$$(#'#'&#,))'"'
*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
•#* $9 ) $
$$ 9; $$ 9
"# ;
/:
*/1.,5
B
C/-,-2**03-/3010/D
3!9
;/<
!
!!/9
!
2/
=3/:
5&#$%6
3!9
;/<
: /
,:/0E031.,
6-*17-/
•!**"-"&"##,"'*-#"#
$ #'##'*-#"
•##,#'#'>?@A5 96#'&"#
•'*-#$#'&"#
&"B&-$
•'#'&"#'*$
"6 "##7
•'&"#C$"
/0E031.,
6/*1E7-/
•&"#D##'&"#"
#*+$"* #E-
•!F$$"
•'#''#'#D"#+-
5*+$"6#''E-$5* #6
6 "##7
•'&"#* &'*$ "#
*-#)'(#'"#D#(
From Agency
theory…
…to “EXTENDED” Agency
theory
: /
,:/0E031.,
6-*17-/
/0E031.,
6/*1E7-/
renis pigmentosa
! "#$% &##'"#%(9"#:
#
'"#"#%#"(#'1'$$#)
9"##)'*"+&'#'*"'*"$
$(#'#'&#,))'"'*-"$"##$%
.Certainly you will know someone, won’t you, Doctor?.
+$"&%C'*#$*$
/0
“EXTENDED” Agency theory in the public
sector
/*
09 )# ) $
*0102
0 G9) $ <
0)9 $ <$8$$6$ <7
-02
0 9 $
3?-102
0 G9##:
2
09 98 9$$
,1=0,16/7
0"! $ #
08H
0 9#
=06, $$ 97
0 $#% 6 87
0$$89$
)
06* $9 7
0#8 "#$
•#) $$$ 9;
, $$ 9 * $9
8 "G9##% ;
*/1.,IJ
C/:
5*" &6
2;//!0
5*+$""#6
2
•#*$*"
,1=0,16/7
•0"! $ #
•08H
•0 9#
/
•#F&#"#'###
#,5*-#6
•&,#"'5,#6
=06, $$ 97
•0 $#%
•0$$89$
)
2
•&"*-#9'
06* $9 7
•0#8 "#$
G/
•#F$""#'$#'C"
22
•#*&"- #%&""##
#'-
/1.0/01
*/1.,IJ
0 ,K3102#%
5*+$""#6
2
•#*$*"
,1=0,16/7
•0"! $ #
•08H
•0 9#
/
•#F&#"#'###
#,5*-#6
•&,#"'5,#6
=06, $$ 97
•0 $#%
•0$$89$
)
2
•&"*-#9'
06* $9 7
•0#8 "#$
G/
•#F$""#'$#'C"
22
•#*&"- #%&""##
#'-
/1.0/01
*/1.,IJ
0 ,K3102#%
5*+$""#6
2
•#*$*"
,1=0,16/7
•0"! $ #
•08H
•0 9#
/
•#F&#"#'###
#,5*-#6
•&,#"'5,#6
=06, $$ 97
•0 $#%
•0$$89$
)
2
•&"*-#9'
06* $9 7
•0#8 "#$
G/
•#F$""#'$#'C"
22
•#*&"- #%&""##
#'-
/1.0/01
*/1.,IJ
0 ,K3102#%
0$ #% ,-:,?0=/3-) $)#
*/1.,I+
C/:
5*" &6
2;//!0
•#* $9 ) $
$$ 9;, $$ 9
#% ;
/:
5*+$""#6
2
•#*$*"
,1=0,16/7
•0"! $ #
•08H
•0 9#
/
•#F&#"#'###
#,5*-#6
•&,#"'5,#6
=06, $$ 97
•0 $#%
•0$$89$
)
2
•&"*-#9'
06* $9 7
•0#8 "#$
G/
•#F$""#'$#'C"
22
•#*&"- #%&""##
#'-
/1.0/01
*/1.,I+
0 =//,#%
0$ #% ,?0=/3-) $)#
•#* $9 ) $
$$ 9; $$ 9
"# ;
/01*/1.,L
/* ->?0 -/3/->
3, 9))#$;$)
) $ ,/0/@00
/30/ "9)) 9
)$< ,/0/
/01
/30/
9 9
$ $##
,/0/@00
-0 #" 9$) 9
) !# )
"!) ,/0/
J7 B;"89 ) $
$$
+7 B %# B
'7 B $ #B
M7 B"9;$$; $
8 #8
A corruption event is …
The “extended agency theory” is more accurate to describe
the relationship between doctor and patient in a complex
context and should be promoted through sta# training and
patient information.
Pro&table moral hazards are also emphasized by patients’
mis-represented and cultural-oriented perception of
relationship…
!/!4
!3
•!)& $E#'$-'*<
•3'#'7'<
•)*B$"*#9 ##N &
D*"#-+H"*'#'
",<
2!2
/
/2C
/
9//2/
5D*$B"-6
Watching with paents’ eyes
&%*-#)'"##$%&#&#&%
##$%*+$"'$#' "$####$&&
&#E-$&%$,$-
'&"*-#9"-+"&#
'#'#'"$&#=&%()'"'#'*+$"
"-'**"'=&%4Can you help
me someway? =
92/
*/1.,IJ
•, >##* 9
9"## O
CI’ll handle thisD
&%*-#)'"##$%&#&#&%
##$%*+$"'$#' "$####$&&
&#E-$&%$,$-
'&"*-#9"-+"&#
'#'#'"$&#=&%()'"'#'*+$"
"-'**"'=&%4Can you help
me someway? =
92/
/* ->?0 -/3/->
3, 9))#$;$)
) $ ,/0/@00
/30/ "9)) 9
)$< ,/0/
/01/30/ 9 9$
$## ,/0/@00
-0 #" 9$) 9
) !# )
"!) ,/0/
2/IJ
*-,2 •!/=:2
!G5(2
!:!/6
•!G!/!
(22/
•K//!L
G/3!!KL
:/!
0
:
/:
/
/::
/ /
=
=
!/!4
!3
0
:
/:
/
/::
/ /
=
!/!4
!3G
0>==
/
!/!4
!3
Professional service is
perceived as a personal care
=
=
#'$%C-
=
•=&%+"$-$!;
•'"-+"+H$",#&B$##'*-#
•3' )##" " "#+M$#&
•+$" ",&**&
2!2/
2#'$9&'#'"#$%&
&M"$#%*&+%:&&(*+$"
*#$
1#'*-(2#'$D*'
-#&#)&:&&4KYou saved my
daughter’s life. How can I return the favour?L:
2!2/92/
2!2/
2#'$9&'#'"#$%&&M"$#
%*&+%:&&(*+$"*#$
1#'*-(2#'$D*'
-#&#)&:&&4KYou saved my daughter’s
life. How can I return the favour?L:
2!2/92/
*/1.,IJ
•, ="< % !#)
) 9 8#"#
•-<"9##* )9# 9!8 #
:
/* ->?0 -/3/->
3, 9))#$;$)
) $ ,/0/@00
/30/ "9)) 9
)$< ,/0/
/01/30/ 9 9$
$## ,/0/@00
-0 #" 9$) 9
) !# )
"!) ,/0/
2/IN
2!2/
*031
•!//!
•!G!2/
G:2
•K!:/!L
G/3!!KL
:/!
2!2/
0
:
/:
/
/::
/ /
=
:
!/!4
!3
2!2/
0
:
/:
/
/::
/ /
=
:
!/!4
!3G
:
*33-:*30/
!:
!/!4
!3
Professional service is
perceived as a GIFT
2!2/
0
:
/:
/
/::
/ /
=
:
!/!4
!3
!/!4
!3G
:
*33-:*30/
!:
:G;
:/0
Marshall Sahlins observed that there are
three distinct types of reciprocity that occur
in human societies around the world:
generalized, balanced, and negative
•Generalized reciprocity is gift giving
without the expectation of an
immediate return
An expection of rewarding arises on the
recipient’s side. It is ambiguous and
uncertain about:
•If (rewarding)
•How (to reward)
•How much (to reward)
#'$%C-
•;B#&D"'&$+"*C"&- "* &
•-#$"#&#'+#'*$"
:
/2C/
''$#'"&$C*"$&#$"#&
'*#$#"%C# #)#'-"
-"&+O$+##'&$C
*"$&#+#''
$C*"$&#'#-"##,$$"-
''&#+#'&"$D*
/2C/92/
/2C/
''$#'"&$C*"$&#$"#&
'*#$#"%C# #)#'-"
-"&+O$+##'&$C
*"$&#+#''
$C*"$&#'#-"##,$$"-
''&#+#'&"$D*
/2C/92/
*/1.,IJ
•, " )
#699)9#7$
/* ->?0 -/3/->
3, 9))#$;$)
) $ ,/0/@00
/30/ "9)) 9
)$< ,/0/
/01/30/ 9 9$
$## ,/0/@00
-0 #" 9$) 9
) !# )
"!) ,/0/
2/IP
/2C/
*-1:
/1*,
•!;!/
•!G!2/
G=
•K:/!L
G/3!!KL
:/!
/2C/
:
/:
/
/::
/ !!/
!/!4
!3
:
/:
/
/::
/
!/!4
!3G
=210/-
!:
!/!4
!3
Professional service is
perceived as a TASK
/2C/
!!/
:
/:
/
/::
/
!/!4
!3;
=210/-
:
!/!4
!3
/2C/
!!/
/103110/-
2/
#'$%C-
•-"* &$###&$C*"$&
*
CONFLICTING RELATIONSHIPS
Agent
INTERPERSONAL RELATIONSHIPS
Coniugal bonds
Partnership
Family bonds
Habitual attendance Severe hostility
EXCHANGE RELATIONSHIPS
Financial credit/debt
Relational credit/debt
Public agency
Professional assignment
Position of representation
EXCLUSIVE INTERPERSONAL
RELATIONSHIPS
INCLUSIVE INTERPERSONAL
RELATIONSHIPS
Mentorship
Profit/Non-profit agency
CREDIT/DEBT RELATIONSHIPS
AGENCY RELATIONSHIPS
Financial relations
INTERPERSONAL PATTERN
CONFLICTING PATTERN AGENCY PATTERN
EXCHANGE PATTERN
!#P10/--/0/
=0-0=
•B$
•B"$##%#&&#
*### #
•"-"#9 #
•#'##9,)$&
"*$9 $
/1:102
•"-"#9"*"#%#
$+#)%##
#'"*$&-#9D*"#-
-3:102
00-/*0/
•"$#9
0-2
•$$%M"*$9 $
?-102