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In addition, a Canadian physician known as Sir William Osler was known as one of the "Big Four" professors at the time that the Johns Hopkins Hospital was first founded.
At the opposite end of this spectrum is the Technocratic Approach to risk communication, in which the physician exerts authoritarian control over the patient's treatment and pushes the patient to accept the treatment plan with which they are presented in a paternalistic manner.
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.
A patient must have confidence in the competence of their physician and must feel that they can confide in him or her.
For most physicians, the establishment of good rapport with a patient is important.
for instance, with patients who do not want to know the truth about their condition.
Furthermore, there are ethical concerns regarding the use of placebo.
Physicians have a tendency of overestimating their communication skills, Extensive research conducted on 700 orthopedic surgeons and 807 patients, for instance, found that 75% of the surgeons perceived they satisfactorily communicated with their patients, whereas only 21% of the patients were actually satisfied with their communication.
Physicians also show a high likelihood of underestimating their patients' information needs and desires, especially for patients were not college educated and from economically disadvantaged backgrounds.
A physician should be aware of these disparities in order to establish a good rapport and optimize communication with the patient.
Additionally, having a clear perception of these disparities can go a long way to helping the patient in the future treatment.