The clinical tête-à-tête of the clinical therapeutic alliance is intrinsic to its exercise. Yet, the cognitive relationship is not symmetrical. Medical care harbours a tension that is revealed by the medical precedence of needs over wants alongside the incommensurability between the patient’s and the doctor’s narratives. But the patient expectancy rather than his satisfaction may reach across the gap that divides these two narratives. Three models of partnership extend from paternalism to autonomy: doctor’s authority, guidance-cooperation, and mutual partnership. Paternalism, first, assumes that the physician should act so as to fill his patient’s health needs and do the best for him irrespective of the passive patients’ contribution. The second position is a consensual cooperative transaction, a tacit contract in which the patient gives up certain freedom to gain some prudential benefits. Much of medical practice is subsumed under this model of asymmetric relationship. The third position is that of mutual participation in which the doctor should be a consultant to the patient heling him to support his autonomy: doctor and patients are dependent on one another.