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Academia and the Profession |

Partnerships in Patient Care: A Contractual Approach

TIMOTHY E. QUILL, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Timothy E. Quill, M.D.; Department of Medicine, The Genesee Hospital, 224 Alexander Street; Rochester, NY 14607.


Rochester, New York


Ann Intern Med. 1983;98(2):228-234. doi:10.7326/0003-4819-98-2-228
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A contractual approach to forming a partnership between doctor and patient is presented in both theoretical and practical terms. Four basic contractual assumptions underly the doctor-patient relationship: both the doctor and the patient have unique responsibilities; the relationship is consensual, not obligatory; both doctor and patient must be willing to negotiate; and each must gain something in the encounters. Clinical examples are used to show practical implications of this model. Although explicit contracts are not needed for all patients, a contractual analysis of doctor-patient interactions helps both participants share the responsibility for patient care.

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