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To the Editor.

Franklyn D. Dornfest, MD
Arch Intern Med. 1982;142(10):1974. doi:10.1001/archinte.1982.00340230224046.
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—Soffer, in his commentary entitled "Searching Questions and Inappropriate Answers" in the June Archives (1982;142:1117-1118), describes a number of styles along the spectrum of physician-patient relationships. He outlines, in a search for the ideal relationship, the advantages and difficulties inherent in each approach. While the motivation for such a search is laudable, it is nevertheless futile, for there can in fact be no ideal style. Too many variables operate during each physician-patient interaction for any one style to prove universally efficacious. Some of these variables include the personality and intelligence of the patient, the personality of the physician, the objective realities of the patient's problem, and the patient's perception of and reaction to his problem. Whether the most efficacious and humanistic style is authoritarian, "permissive with patient self-determination," "paternalistic with permission," or based on "mutual participation" will be determined by the nature of the variables just mentioned.

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