The Importance of Healthy Doctor-Patient Relationships
The ultimate objective of any doctor-patient communication is to improve the to good communication in the doctor-patient relationship, including patients' anxiety . allowing for a view from a different perspective, drawing attention for a better. Figure Viewer; Download Figures (PPT) In some extreme recent cases, the relationship has broken down to the point where But, central to the success of the doctor–patient relationship is that doctors View Large Image. The Patient-Doctor Relationship. Sonia Sehgal, M.D.. Course Director CFI. Associate Clinical Professor. Department of Internal Medicine. UC Irvine Program in.
As an alternative, medical journals and professional health organizations may represent even more valuable sources, for they offer assessment and dissemination of the best evidence for clinical problems. Referenced Web sites may be explicitly recommended to patients during clinical encounters or by electronic mail.
It then becomes important for physicians to know where high caliber information is located in cyberspace rather than merely know what the specific information is itself [ 24 ]. Given how difficult it is for health professionals to keep track of the ever-changing Web, it becomes equally important to know about quality repositories of medical links.
The "healthfinder" Web site selects links to health information from sources that include government agencies, nonprofit and professional organizations serving the public interest, universities and other educational institutions, libraries, and so on [ 30 ].
This site was developed by the US Department of Health and Human Services to provide up-to-date resources beyond what physicians have time to prepare on their own. Physicians may feel more comfortable recommending information from MEDLINE plus rather than a "dot-com" source of medical information, which often endorses products or companies.
Despite the existence of quality repositories of health information, there is still significant resistance to online physician activity. Many have a "fight or flight" response to these technical communicative innovations, creating a challenge in implementation [ 33 ]. The Research Agenda Though there have been previous studies analyzing the patient-physician relationship, research must be directed toward evaluating the impact of electronically obtained knowledge on this relationship. Further analysis of the current models for the patient-physician relationship may reveal that new, emerging trends are taking place.
Efficiency, patient satisfaction, and clinical encounter time may vary when Internet-acquired information is considered in decision-making. Variability in patient types and in physician personalities compounds the dynamics of decision-making analysis. Additional focus must be placed on studies that include the impact of electronically obtained knowledge on the patient-physician relationship. Another issue that should be addressed is the extent of responsibility that a patient is willing to accept.
In one pilot study, individuals have been given access to their medical records and have been provided with online communication with their physicians derived from Web-based methods of sharing clinical content [ 34 ]. Patient interest, as well as physician acceptance, has been evaluated.
In another pilot project, patients are being provided with consumer health information in waiting and exam rooms [ 35 ]. The resulting patient-physician communication and level of satisfaction will be measured.
When patients assume a greater role in acquiring medical knowledge, there must be a corresponding change in the physician's role as treatment decision-maker. Additional dynamics are likely to result from different physician behaviors, including embracing, avoiding, or disregarding Internet-derived information.
To better define this variable, surveys and observational studies are needed that will elicit physician attitudes toward Internet health information and their corresponding patient-physician relationships. In addition, research is needed to evaluate the barriers to physician implementation of information technology.
In Canada, researchers have administered a new survey instrument to stratify primary care physicians into different levels of information technology usage [ 36 ].
This approach may allow for specifically tailored strategies to be used in implementation. Although many individuals have the potential to gain medical knowledge easily through on-line information, others do not. Few studies have examined the benefit of computers in patient education within economically depressed urban areas [ 37 ]. There is also little evidence that describes how individuals lacking the latest technology including high-speed Internet Service Providers cannot access resource-intensive Web sites, including those requiring audio or video streaming.
The long-term effects and potential benefits of computer technology for vulnerable populations have yet to be determined. Although there is a considerable amount of data that demonstrate limited access, there still is overwhelming interest in computer education by all segments of the public.
Additional research is necessary to define how patients of different cultural or socio-economic backgrounds utilize computers and the Internet for information, and how this has an impact on their relationship with healthcare providers. Most patients using a home computer have access to medical information on the Internet. This circumstance will likely reflect a select, educated patient population with income levels that support the equipment.
Yet there was significant interest expressed in on-line health information. If minority patient populations are to become active participants in the Internet age, it is necessary to continue to devote greater resources to improving easy access of electronic information.
There is a definite need for interventions that empower ethnic minority patients and help them become informed and active healthcare consumers [ 39 ]. Patients with poor literacy skills are less likely to take advantage of the Internet in order to acquire additional medical knowledge, whether they have access or not.
Unfortunately, because these individuals are more likely to have worse health, their needs for health education are greater, especially for those with chronic illnesses [ 40 ].
This issue affects their relationship with physicians; studies have shown that patients' acceptance of diagnoses and treatment plans depends on education [ 41 ]. Hence, additional efforts are required to assist persons with lower literacy skills.Conversation between a doctor and patient
With adaptive technologies supplying touch-screen input and audio output, kiosks can be made available for patients motivated to learn, independent of their literacy or education level [ 4243 ].
Physician offices with health information kiosks may be an alternative method for browsing health-related information, being temporally linked to clinician interactions. However, additional issues, such as cost, complexity of use, and potential for misinformation, then arise [ 44 ].
Still, additional research is necessary to determine the possible benefits and effects on the patient-physician relationship. In sum, the research agenda on on-line information and the patient-physician relationship includes: Conclusions The Internet Age is altering the patient-physician relationship.
If physicians actively assist patients in the information-gathering process, an improved relationship may result. Through the understanding of evolving professional roles, the decision-making process between physicians and patients may improve with efforts to share the burden of responsibility for knowledge.
This change could usher in a new era of the patient-physician relationship, with a potential gain for all collaborative parties. However, there is no assurance that implementation will occur smoothly or in a desirable fashion.
Doctor–patient relationship - Wikipedia
Thus, there is a compelling need for prospective research in this area. Methods of bridging the Digital Divide are also important considerations for future research, for this disparity in technology use still exists today [ 45 ].
It is essential that large segments of the population not be left behind as strides are made in information technology and healthcare decision-making. Acknowledgments We are indebted to Paul Heckerling, M. Towards quality management of medical information on the internet: BMJ Nov 28; An evidence-based approach to interactive health communication: Science Panel on Interactive Communication and Health. JAMA Oct 14; The next transformation in the delivery of health care.
N Engl J Med Jan 5; 1: Rating health information on the Internet: JAMA Feb 25; 8: Assessing, controlling, and assuring the quality of medical information on the Internet: Caveant lector et viewor--Let the reader and viewer beware. JAMA Apr 16; Health Information on the Internet: Special strategies of integrated care may be required where multiple health care providers are involved, including horizontal integration linking similar levels of care, e.
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. 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. What are the qualities that make a good doctor? Certainly, experience and credentials matter. Trust is the foundation of any relationship, and doctor-patient relationships are no exception.
Doctor-Patient Communication: A Review
Research has uncovered some of the specific doctor behaviors that are most associated with patient trust—among them, caring, competence, and attentiveness. Open, two-way communication Communication begins from the moment you first meet your doctor. Does she greet you warmly? Does he listen attentively as you describe your symptoms and concerns? Does she interrupt you, talk over you, or seem to dismiss your worries? Your doctor should take your complete history, ask you plenty of questions, and encourage you to talk openly and honestly about your situation.
He should take his time, listening attentively to your concerns. Most doctors are pressed for time today for a variety of reasons, but a doctor who rushes through your visit not only risks making uninformed decisions about your care and treatment, he or she also misses an opportunity to establish a meaningful relationship with you.
If you feel rushed, unheard, dismissed, confused, or unsure during your visit, calmly let your doctor know. Remember that your doctor is a trained professional who needs to know the whole picture in order to accurately diagnose and treat your condition.
Also, keep in mind that healthcare providers are only human—being rude or aggressive toward doctors, nurses, and other healthcare personnel is not only distracting and stressful for these caregivers, it can also lead to medical mistakes.