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Patient Doctor Relationship

The document discusses the importance of effective communication in the patient-doctor relationship, highlighting its role in improving patient satisfaction, compliance, and health outcomes. It outlines various communication strategies, including active listening and empathy, while also examining different models of doctor-patient relationships such as paternalism, consumerism, and mutuality. The evolution of these relationships is noted, with a shift towards greater patient autonomy and collaboration in modern healthcare.

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8 views

Patient Doctor Relationship

The document discusses the importance of effective communication in the patient-doctor relationship, highlighting its role in improving patient satisfaction, compliance, and health outcomes. It outlines various communication strategies, including active listening and empathy, while also examining different models of doctor-patient relationships such as paternalism, consumerism, and mutuality. The evolution of these relationships is noted, with a shift towards greater patient autonomy and collaboration in modern healthcare.

Uploaded by

smarny.kroplowka.4f
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as KEY, PDF, TXT or read online on Scribd
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The Patient-Doctor

Relationship

Lek. dent. Krzysztof Gębczyński


Katedra Stomatologii Zachowawczej z
Endodoncją
Instytut Stomatologii Wydziału Lekarskiego
Uniwersytet Jagielloński - Collegium Medicum
Kierownik Katedry: prof. dr hab. n. med. Joanna
Zarzecka, prof. UJ
Objectives

Understand why patient-


doctor communication is key
to a successful relationship

Learn basic communication


strategies for an improved
patient-doctor experience
The Patient-Doctor
Relationship
Class exercise:
Tell me about your most
memorable positive
experience with a physician
(when you were a patient)
The Patient-Doctor
Relationship
Class exercise:
Tell me your most negative
experience
The Patient-Doctor
Relationship

What does being a doctor


mean to you?
Communication

Patient-Doctor
communication is important
Improved satisfaction
Improved compliance
Improved decision making
Better health outcomes
Decreased malpractice claims
Communication Skills

Essential for diagnosing and


treating illness
Essential in establishing a
meaningful patient-doctor
relationship
Facilitates educating and
counseling patients
Communication

Information gathered must


be:
Objective
Accurate
Precise
A model patient-doctor
relationship
Trust
Compassion
Open and honest
communication
Respect
Why is Doctor-Patient
Communication Unique?

Trust
Patients on the first visit
share their most personal
information to someone they
have never met before
They look to you for guidance
when making critical health
care decisions
Why is Doctor-Patient
Communication Unique?

Trust
Within minutes of meeting,
patients are often required to
disrobe for a physical
examination and are placed
in a vulnerable situation
Communication

Who will you be


communicating with?
Patients
Families
Colleagues
Other health professionals
Patient Communication

Patients who feel at ease


are more likely to tell you
their reason for coming to
the doctor’s office
Be yourself!
Show true interest
The Physician’s Duties

Respects the patient


Ensures privacy and trust of
confidential information
Demonstrates genuine
concern for patient’s health
Limits distraction to provide
patient undivided attention
Respect

Introduce yourself
Patient
Family
Caregiver
Respect

Explain your role and goal


for the interaction
Respect

If appropriate shake hands

Always address the patient


as: Mr., Mrs., Ms, etc.
Empathy

To understand a person’s
experience
Different than sympathy
Requires
Active listening
Interest in patient’s
experience
Objectivity

Removing your own beliefs


and values
Avoid judgmental attitudes
IV Drug Abuse
Education
Socioeconomic status
Language/Cultural differences
Ageism
Active Listening Skills

Respect the patient as a whole


person, not a diseased body
Use confirmatory statements:
“Yes”
“Tell me more about that”

Allow the person to tell their


whole story without
unnecessary interruptions
Active Listening

Don’t be afraid of silence


Body Language

Examination room
configuration
Sitting/Standing
Eye level
Eye contact
Note taking
Posture
Hurried speech
Body Language

Patients notice more than


you think
2/3 of communication is non-
verbal
Appropriate use of touch
Patient-Doctor Communication:
Key Points

Ask about expectations,


feelings and concerns
Show concern for comfort and
modesty
Give an opportunity to
express feelings and concerns
Encourage patients to ask
questions
Communication skills can be
developed with practice, patience
and a willingness to learn
Parsons model
Parson saw the doctor and patient as
fulfilling necessary functions in a well
balanced and maintained social
structure
Sickness is considered to be a
necessary, occasional respite,
providing a brief exemption for
patient from social responsibilities
Paternalism
Is widely regarded as the traditional
form of doctor-patient relationship
A passive patient and a dominant
doctor
Patients role
When sick, a patient is allowed the
privileges of convalescence-he or she
is not held responsible for poor health
and is excused from everyday
responsibilities
In order to enjoy these privileges, the
patient must seek technically
competent help and comply with
medical advice
?passive and dependent
Doctors role
The doctor legitimates the patients
illness and determines the course of
treatment.
In doing so, the physician is compelled
by professional ethics to act only in his
or her sphere of expertise, to maintain
an emotional detachment and distance
from the patient, and to act in the
patients best interest
?professionally dominant and
autonomous
Advantages
The supportive nature of paternalism
appears to be all the more important
when patient are very sick at their
most vulnerable
Relief from the burden of worry is
curative in itself, and the trust and
confident implied by this model allow
doctor to perform medical magic ?
placebo
Disadvantages
It is the potential for legitimate medical
authority to be used for manipulation
and exploitation of the vulnerable and ill
that has fueled the ascendance of the
autonomy doctrine to the preeminent
bioethical value in patient-physician
relationships.
Consumerism
The patients challenge to unilateral
decision making by physicians in
reaching closure on diagnoses and
working out treatment plans
Reversing the very basic nature of
the power relationship
Patients role
Health shoppers
Indications of consumer
behavior
Cost-consciousness
Information seeking
Exercising independent
judgment
Consumer knowledge
Doctors role
Health care providers
Technical consultant
To convince the necessity of medical
services
A tendency for the consumer to be
right
Advantages
Patients can have their own choices
Medicine is not an accomplished
science. There are tremendous gaps in
knowledge. Indeed, it has been
estimated that the effectiveness of
treatment is unknown for about 90 of
the medical condition seen in routine
practice
Disadvantages
Patients are being more selective in the
acceptance of provider advice, based on
its cost
When things seem to go wrong, when
satisfaction is low, or when a patient
suspect less than optimal care or
outcome, patients are more likely to
question physician authority
Mutuality
The optimal doctor-patient relationship
model
This model views neither the patient nor
the physician as standing aside
Each of participants brings strengths and
resources to the relationship
Based on the communication between
doctors and patients
Patients role
Patients need to define their problems in
an open and full manner
The patients right to seek care
elsewhere when demands are not
satisfactorily met
Doctors role
Physicians need to work with the
patient to articulate the problem and
refine the request
The physicians right to withdraw
services formally from a patient if he
or she feels it is impossible to satisfy
the patients demand
Advantages
Patients can fully understand what
problem they are coping with through
physicians help
Physicians can entirely know patients
value
Decisions can easily be made from a
mutual and collaborative relationship
Disadvantages
Physicians do not know what certain
degree should they reach in
communication
If the communication is fake, both
physicians and patients do not have
mutual understanding, making decision is
overwhelming to a patient
Doctor-patient relationship in
the past
Paternalism
Because physicians in the past are
people who have higher social status
doctor is seen as a sacred occupation
which saves peoples lives
The advices given by doctors are seen
as paramount mandate
Doctor-patient relationship at
present
Consumerism and mutuality
Patients nowadays have higher
education and better economic status
The concept of patients autonomy
The ability to question doctors

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