The Importance of Healthy Doctor-Patient Relationships
The doctor-patient relationship has undergone a transition throughout the ages. Prior to the last two decades, the relationship was predominantly between a. The doctor–patient relationship has been and remains a keystone of care: the medium in which data are gathered, diagnoses and plans are made, compliance . Thieme is an award-winning international medical and science publisher serving health professionals and students for more than years.
The relationship therefore directly determines the quality and completeness of information elicited and understood. It is the major influence on practitioner and patient satisfaction and thereby contributes to practice maintenance and prevention of practitioner burnout and turnover, and is the major determinant of compliance. Effective use gives patients a sense that they have been heard and allowed to express their major concerns, 17 as well as respect, 18 caring, 19 empathy, self-disclosure, positive regard, congruence, and understanding, 20 and allows patients to express and reflect their feelings 21 and relate their stories in their own words.
Other aspects important to the relationship include eliciting patients' own explanations of their illness, 2324 giving patients information, 2526 and involving patients in developing a treatment plan.
The accessibility of personnel, both administrative and clinical, and their courtesy level, provide a sense that patients are important and respected, as do reasonable waiting times and attention to personal comfort.
The availability of covering nurses and doctors contributes to a sense of security. Reminders and user-friendly educational materials create an atmosphere of caring and concern. Organizations can promote a patient-centered culture, 29 or one that is profit- or physician-centered, with consequences for individual doctor—patient relationships. Organizations as well as whole health care systems can promote continuity in clinical relationships, which in turn affects the strength of in those relationships.
For instance, a market-based system with health insurance linked to employers' whims, with competitive provider networks and frequent mergers and acquisitions, thwarts long-term relationships.
The Importance of Healthy Doctor-Patient Relationships
A health plan that includes the spectrum of outpatient and inpatient, acute and chronic services has an opportunity to promote continuity across care settings. The competition to enroll patients is often characterized by a combination of exaggerated promises and efforts to deliver less. Patients may arrive at the doctor's office expecting all their needs to be met in the way they themselves expect and define. They discover instead that the employer's negotiator defines their needs and the managed care company has communicated them in very fine or incomprehensible print.
Primary care doctors thus become the bearers of the bad news, and are seen as closing gates to the patient's wishes and needs. When this happens, an immediate and enduring barrier to a trust-based patient-doctor relationship is created. The doctor—patient relationship is critical for vulnerable patients as they experience a heightened reliance on the physician's competence, skills, and good will. The relationship need not involve a difference in power but usually does, 30 especially to the degree the patient is vulnerable or the physician is autocratic.
United States law considers the relationship fiduciary; i. In most scenarios, a doctor will walk into the room in which the patient is being held and will ask a variety of questions involving the patient's history, examination, and diagnosis. This can go a long way into impacting the future of the relationship throughout the patient's care. All speech acts between individuals seek to accomplish the same goal, sharing and exchanging information and meeting each participants conversational goals.
A question that comes to mind considering this is if interruptions hinder or improve the condition of the patient. Constant interruptions from the patient whilst the doctor is discussing treatment options and diagnoses can be detrimental or lead to less effective efforts in patient treatment.
Doctor–patient relationship - Wikipedia
This is extremely important to take note of as it is something that can be addressed in quite a simple manner. This research conducted on doctor-patient interruptions also indicates that males are much more likely to interject out of turn in a conversation then women. These may provide psychological support for the patient, but in some cases it may compromise the doctor—patient confidentiality and inhibit the patient from disclosing uncomfortable or intimate subjects. When visiting a health provider about sexual issues, having both partners of a couple present is often necessary, and is typically a good thing, but may also prevent the disclosure of certain subjects, and, according to one report, increases the stress level.
Family members, in addition to the patient needing treatment may disagree on the treatment needing to be done. This can lead to tension and discomfort for the patient and the doctor, putting further strain on the relationship.
Bedside manner[ edit ] The medical doctor, with a nurse by his side, is performing a blood test at a hospital in A good bedside manner is typically one that reassures and comforts the patient while remaining honest about a diagnosis.
Vocal tones, body languageopenness, presence, honesty, and concealment of attitude may all affect bedside manner. Poor bedside manner leaves the patient feeling unsatisfied, worried, frightened, or alone. Bedside manner becomes difficult when a healthcare professional must explain an unfavorable diagnosis to the patient, while keeping the patient from being alarmed.
Rita Charon launched the narrative medicine movement in with an article in the Journal of the American Medical Association. In the article she claimed that better understanding the patient's narrative could lead to better medical care.
First, patients want their providers to provide reassurance. Third, patients want to see their lab results and for the doctor to explain what they mean.
Fourth, patients simply do not want to feel judged by their providers.
And fifth, patients want to be participants in medical decision-making; they want providers to ask them what they want. Please help improve this article by adding citations to reliable sources. July Learn how and when to remove this template message Dr. Gregory House of the show House has an acerbic, insensitive bedside manner.The Doctor-Patient Relationship with Abraham Verghese
However, this is an extension of his normal personality. Busy and uncomfortable clinics may make it harder for the doctor and patient to connect High patient-provider ratioa Knowledge: Patients may feel like they are objects being discussed, rather than as equals participating in their own care; they may not feel as though they know all of the team members and what their roles are Trust: There may be too many people with whom to establish rapport Knowledge and regard: Whenever possible, limit the number of physicians who round on a patient at one time; in teaching hospitals, where this is not always possible, team members should introduce themselves to the patient outside of rounds to establish rapport and to know the patient Urgent care setting eg, emergency department, clinic Knowledge: The doctor and the patient may not know each other Knowledge: The patient and the physician may be less inclined to invest effort in establishing rapport if they know they will not see each other again Regard: Take the time to establish rapport and to make the patient feel comfortable whenever possible Loyalty: Clinics may not be set up for longitudinal care eg, in the emergency department Loyalty: Set up follow-up appointments with established providers before discharging the patient Cost Regard: The patient may harbor resentment about medical bills Knowledge: The patient may be reluctant to see a doctor due to financial concerns Documentation burden Knowledge: Physicians may spend much of the visit making sure all the necessary computer boxes are checked rather than getting to know the patient as a person; having a computer between the patient and the doctor also makes it hard for the patient to feel like he or she knows the doctor Several time-saving strategies can be employed to reduce the amount of time spent on documentation and increase the time available for physicians to spend with patients Embrace technology: Physicians may spend much of the visit facing the computer screen rather than the patient, which may make the patient feel as though the doctor does not care about him or her as a person; the amount of paperwork and documentation that is often required also enhances physician burnout, making it harder for the physician to demonstrate empathy and caring Use dictation software to speed note-writing When appropriate, write a note collaboratively with the patient during the visit; if using this approach, either turn the screen so that the patient can see it as well or arrange seats so that the physician can maintain eye contact with the patient while he or she is typing the notes aRefers specifically to teaching rounds, wherein a large team of providers visits a patient as a group.