Doctor – Patient Relationship

This relationship is the focal point of all medical practice

Factors influencing this relationship

• Lack of information given to the patient.
• Lack of common language leads to communication gap.
• Poor recall of patients for information and advice given to them.
• Lack of interest of doctors and low empathy.
• Kind of the relationship (active – passive – reciprocal).

Good communication between patient and doctor depend on:

• Expectation of patient
• Cultural background
• Previous experience with illness and doctors
• Physical and emotional state
• Childhood developmental experience
• Personality style
• Transference reaction (-ve / +ve)
• Counter transference reaction

Guidelines for good doctor-patient relationship:

• Doctor must be courteous and respectful and acknowledge the patient’s feelings about being interviewed.
• Suitable environment which influence the difficulty of relationship.
• Involvement of important persons to the patient.
• Minimize interruptions.
• Enough time for the meeting.
• Doctor should always sit down to be at eye level with the patient.
• Closeness of the therapeutic relationship must be modified according to the needs of the patient.

Good doctor patient relationship depend on therapeutic techniques

• Education
• Focusing on problem solving
• Setting reasonable expectations for change
• Expressing emotions effectively
• Crisis intervention
• Concrete limit setting
• Managing dependence

Impact of good doctor-patient relationship:

Direct: Good compliance

Indirect: Valid psychiatric interview

Good outcome

Factors in the doctor-patient relationship affect the compliance:

• Perception of the physician as rejecting and unfriendly
• Failure of the physician to explain the diagnosis or causes of symptoms
• Doctor’s awareness of and sensitivity to the patient’s belief system
• Physician enthusiasm, permissions, time spent talking with the patient
• Physician experience