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To Care Is to Coprovide

Department of General Practice and Primary Health Care, University of Auckland, Auckland, NZ

CORRESPONDING AUTHOR: Stephen A. Buetow, PhD, Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland, NZ 1004, s.buetow{at}auckland.ac.nz

ABSTRACT

Although primary care, including family medicine, recognizes different types of clinician-patient interaction, I argue that only interactions characterized by coprovision define care. By coprovision I mean that clinicians and patients each provide the expertise in health care that they have the capacity to contribute in any given situation. I argue that paternalism and consumerism cannot signify care in any real sense. Some implications of this analysis include a reconceptualization of family medicine and its defining attributes; support for features of caring relationships, such as mutual responsiveness and responsibility; and an acknowledgment that clinicians and patients need to be self-regarding as well as other-regarding. In a previous issue of the Annals, I called for a new dictionary for family medicine, one that would redefine attributes of family medicine in ways not exclusively clinician-centric. Specifically, it would acknowledge the role of patients and their informal caregivers as coproviding, not merely consuming, health care.

Key Words: Delivery of health care • physician-patient relations • health services research • professional practice

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