Revisiting the patient-physician relationship under the lens of value co-creation and defensive medicine

Purpose This study formulates a new archetypical model that describes and re-interprets the patient-physician relationship from the perspective of two widespread phenomena in the healthcare delivery process: value co-creation (VCC) and defensive medicine (DM). Design/methodology/approach Grounded in the existing literature on VCC and DM, the authors designed and conducted 20 in-depth interviews with doctors (and patients) about their past relationships with patients (and doctors). After putting the recorded interviews through qualitative analysis with a three-level coding activity, the authors built an empirically informed model to classify patient-physician relationships. Findings The authors identified four archetypes of patient-physician relationships. Each archetype is described along with its representing characteristics and explained in terms of its consequences as they relate to VCC and DM. Research limitations/implications This research contributes to the literature on both VCC in healthcare and DM, in addition to the patient-physician's relationship literature. Practical implications Being aware of patient-physician relationship mechanics, building long-term relations with patients and investing in service personalization and patient-centred care can effectively mitigate the risks of DM behaviours on one side while increasing the likelihood of VCC actualization on the other. Originality/value Although strictly linked to the interactions between patients and doctors, VCC and DM are typically considered disentangled. In this research paper, the authors identified four archetypes of patient-physician relationships in relation to these two phenomena.