Relação médico-paciente: da assimetria histórica à autonomia contemporânea – uma revisão de literatura

Introduction: The doctor-patient relationship, historically marked by asymmetries of power and knowledge, has undergone significant transformations in recent decades, driven by sociocultural changes, technological advances, and the growing emphasis on patient autonomy [1,2]. The traditional biomedical model, centered on the physician, is gradually giving way to more humanized and participatory approaches, such as the Patient-Centered Clinical Method (PCCM), which acknowledges the individual's wholeness and the importance of effective communication [1,3]. Objective: To investigate how the doctor-patient relationship is constructed in everyday healthcare practices, considering that the effectiveness of care is directly related to the individual's subjectivity. Methodology: This is a descriptive study and literature review conducted in the SciELO, BVS, Google Scholar, and LILACS databases. Twenty articles published in Portuguese between 2020 and 2024 were included, using the DeCS descriptors: Health Care and Physician-Patient Relations. Results: The analysis revealed that the quality of the doctor-patient relationship is associated with clear communication, empathy, continuity of care, and cultural competence. Persistent barriers include physician-centered practices, communication difficulties, and structural limitations within health services [1]. Studies show that patient-centered practices improve treatment adherence, symptom control, and overall satisfaction [3]. Final Considerations: Healthcare requires a comprehensive and humanized approach that respects the patient's particularities and promotes autonomy. This demands multiple skills from physicians, including active listening, empathy, cultural competence, and an ethical commitment to shared responsibility in care.