Table of Contents:
- The Importance of a Doctor-Patient Relationship
- Physician-Patient Communication and Other Important Practices
- 3 Models of Doctor-Patient Relationships
- What Patients Look for in a Physician-Patient Communication?
- Guidelines to Define Doctor-Patient Relationship in the Era of Virtual Care
In the words of Thomas L. Delbanco, MD, who in their paper, “Enriching the Doctor-Patient Relationship by Inviting the Patient’s Perspective” (1992), stated the importance of doctor-patient relationship and what patient’s look for in their medical encounter with a physician:
“The patient wants to be able to trust the competence and efficacy of their caregivers. They want to be able to negotiate the health care system effectively and to be treated with dignity and respect. Patients want to understand how their sickness or treatment will affect their lives, and they often fear that their doctors are not telling them everything they want to know. Patients worry about and want to learn how to care for themselves away from the clinical setting. They want us to focus on their pain, physical discomfort, and functional disabilities. They want to discuss the effect their illness will have on their family, friends, and finances. And they worry about the future.”
The Importance of a Doctor-Patient Relationship
The importance of doctor-patient relationship: The start of a good doctor-patient relationship is from their initial meeting – the assessment session, for which the doctor has to assess their patient’s illness. The initial consultation allows the doctor to gather an in-depth analysis of their patient to make the right and appropriate diagnosis. The doctor also recommends different therapies to support the patient’s recovery. This process establishes the beginning of a healthy, professional doctor-patient relationship. A doctor’s care is founded on good rapport and physician-patient communication so that information can flow easily between them and their patient, which later becomes crucial to effective care and physician-patient relationships. Why is this the case, you ask? A good rapport between the doctor and their patients can help:
- gather relevant patient data, used for diagnosing conditions and forming treatment plans
- patients to comply with care instructions for their healing after recovery
- figure out the best ways to support and care for the patient
- retain a satisfied patient, once treatment is complete
The importance of doctor-patient relationship is that it is essential for doctors to be trusted by their patients so that they can have full disclosure on their medical history and other relevant information crucial for diagnosis and treatment. A study was done by Harvard Medical School also suggests that having a good rapport with patients can also improve a patient’s health. Strategies for doctors to achieve this may include making more eye contact with their patients, paying close attention to the patient’s demands and emotions, and helping them to set their health goals. “A good relationship fosters better physician-patient communication, which improves diagnosis. It also encourages people to tell their doctors about symptoms they might not otherwise disclose,” says the lead author of this study, Dr. John Kelley, a psychologist at Massachusetts General Hospital. In some cases, patients who are anxious or aren’t put at ease by their doctors may have difficulty understanding their doctors which leads to them missing out on important information. So, trust and confidence in doctors can help patients regulate their emotions.
One way to increase patient satisfaction and better the physician-patient relationships is to request feedback, for example, “Does the patient comprehend what is being discussed? Is the discussion compatible with the patient’s language or vocabulary?”
A successful communication should include the following for a doctor:
- That it is simple and straightforward
- That it is specific
- That the important points are repeated
- That there is little usage of medical jargons
- A regular check with the patient to make sure they understand
Physician-Patient Communication and Other Important Practices
For the successful treatment of a patient, it is imperative to have a good doctor-patient relationship. The importance of doctor-patient relationship is a one-on-one analysis between a doctor and patient explores underlying issues and works through them. Such an analysis is typically part of a comprehensive diagnostic evaluation. Let us explore what these important practices are for one-on-one analysis to happen effectively between physician-patient relationships for the benefit of the treatment and recovery.
- Maintaining Eye Contact – There is nothing worse for a patient to walk into a consulting room and not get any eye contact from their doctor. It is best to greet the patient and make them comfortable so that the patient doesn’t feel unacknowledged or uncomfortable to share their medical history and talk about their condition/illness easily.
- A Healthy Partnership – A healthy partnership between physician-patient relationships would mean exploring the patient’s ideas about their illness/condition, which includes their thoughts, worries, expectations, feelings, etc with them and taking the patient’s input seriously.
- Effective Communication – Doctor-patient communication is the key to a successful consultation. Doctors should understand that many patients feel themselves entering “alien territory” when they make a visit to the doctor. Sometimes, it is even possible for them to feel scared, which can lead to them not comprehending what the doctor is saying, and missing on key information that the doctor tells them. As it is possible for doctors to have trouble understanding a patient’s explanation of their symptoms, it is also possible for patients to gather a doctor’s explanation of their diagnosis.
- Giving Patients Enough Time – There may be a case where the patient would require to spend more time with the doctor; they would need the additional time to be able to explain their issues or to have the doctor explain to them why they are going through what they are going through. This doesn’t sit well with the fact that our country is currently facing a shortage of doctors, and so a doctor’s time is valuable to attend to every patient. However, it doesn’t mean that to attend to one patient, the doctor should give less time to the other since every patient’s treatment is equally important.
- Regular Appointments – According to Wait Time Report, 1 in 5 patients have changed doctors because of long wait timings. What patients want is to get to see their doctor within a reasonable time, without having to wait for too long. Regular appointments assure that the patient is being attended to from their first diagnosis to their recovery.
3 Models of Doctor-Patient Relationships
From their article released in 1956, Szasz and Hollender outlined 3 basic models of the doctor-patient relationship.
The active-passive model is the oldest model out of the three. It is based on the doctor acting upon the patient rather than with them as they are treated as an object. This model works well in certain situations, such as an emergency when the patient may be unconscious or when a delay in the treatment could cause some harm. In this model, consent and doctor-patient communication in length are not present.
In the Guidance-Cooperation model, a doctor holds the power because of their advanced medical knowledge over the patient, who lacks it. This is the reason why the doctor decides for the patient and makes their recommendations accordingly. Then the patient has to follow these recommendations judicially.
Mutual Participation Model
In this model, the doctor-patient relationship is treated as an equal partnership. Since the patient is seen as an expert in their goals and life experiences, it makes their involvement necessary for the development of the treatment. The doctor only has to obtain the patient’s goals and help them reach it. The equal partnership means mutual dependence and engagement in activities satisfying both doctor and the patient. For a one-on-one analysis situation, mutual participation stands as the most effective model.
All these models can be appropriate for specific situations, but over the last several decades the mutual-participation mode has garnered maximum support whenever it is medically feasible.
What Patients Look for in a Physician-Patient Communication?
Doctor-patient communication: For a successful doctor-patient relationship to happen, the doctor needs to determine what a patient wants from them. Is it effective communication in a way that is easier for them to comprehend? It is known that patients tend to thrive in their communication when they feel they are an integral part. Healthcare professionals believe these are some of the best practices for healthy doctor-patient communication:
- Development of a good interpersonal relationship
- Allowing the exchange of information to happen by asking and providing both
- Facilitating the patients to be part of decision making
- Fostering the doctor-patient relationship
- Responding to their emotions about their sickness
- Enabling disease and treatment-related behavior
Guidelines to Define Doctor-Patient Relationship in the Era of Virtual Care
In 2016, the American Medical Association AMA issued new guidelines to follow telemedicine that defines the doctor-patient relationship in the era of virtual care. The policy claims that even though the technology is new and different, the doctor’s responsibilities should be the same for their patients. Doctors should always do the following:
- Show any interests related to telehealth technology
- Protect a patient’s privacy
- Inform the patient of any service limitations, if there are any
- Encourage the patients to inform their primary care doctor about their online visit
- Make sure that the patient understands how the technology works
The AMA also suggests that the doctor-patient relationship should exist prior to their online visit. This relationship can be established by:
- Face-to-face interaction and examination through an in-person visit or through real-time video and audio conferencing.
- There should be a previous consultation with the physician that already has a relationship with the patient.