The Doctor–Patient Relationship
Patient shakes hands with doctor, Doctor Visit Tips relationship with your doctor is all about your health, of course, but it's also about mutual trust, communication and understanding. How can you establish such a relationship and keep it on track? . Quiz: What problems do low-income seniors face?. When patients develop this trust, they are more likely to comply with doctors And, I talked about developing a “relationship” with your doctor so you can effectively communicate. Keep track of your care (participate in your care). . Tx for Opioid Addiction · Quiz Time: What's the Latest FDA Warning?. Patients have an obligation to maintain confidentiality, just as doctors do. a. Physicians are legally and morally permitted to 'fire'a patient (to ask a patient to find and Fins discuss several alternative models of the doctor-patient relationship.
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. 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.
7 Ways to Make the Most of Your Doctor Visit
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. Thus, providing health care, and being a doctor, is a moral enterprise. An incompetent doctor is judged not merely to be a poor businessperson, but also morally blameworthy, as having not lived up to the expectations of patients, and having violated the trust that is an essential and moral feature of the doctor—patient relationship.
Deception or other, even minor, betrayals are given weight disproportional to their occurrence, probably because of the vulnerability of the trusting party R.
Thus, a single organization may both provide and pay for care. Organizations as providers have duties such as competence, skill, and fidelity to sick members. Organizations as payers have duties of stewardship and justice that can conflict with provider duties.
Managed care organizations thus have conflicting roles and conflicting accountability. An organization's accountability to its member population and to individual members has a series of inherent conflicts.
Is the organization's primary accountability to its owners, to employer purchasers, to its population of members, or to individual, sick members? If these constituents somehow share the accountability, how are conflicting interests resolved or balanced?
Be the squeaky wheel If you raise a question about your illness that stymies your doctor, don't just nod and let the matter drop. Ask if she can follow up and find the answer or if she'd rather refer you to a doctor who routinely deals with this problem. You may feel uncomfortable about suggesting an appointment with another doctor, but it's a reasonable request and it's better for both of you that you propose it rather than leave the office feeling annoyed.
Make your priorities clear When your doctor recommends a medical procedure or nonemergency surgery, he'll provide you with basic information and perhaps a brochure, but you need more than one-size-fits-all information before you decide on a course of action. Ask him if you can schedule a short follow-up call or an email to give you time to think it through, suggests Richard A.
The Doctor-Patient Relationship — Truth Prescriptions with Dr. Errin Weisman
What may matter to you is how long it will take to heal, when you can go back to work, if you can continue with your favorite sport, whether you can still live independently and if there are any alternatives to what he suggested.
Talking with him about what's important to you can help you decide what to do — and it's one of the most valuable conversations the two of you will have. How can I reach you? Getting in touch with your doctor between appointments can be frustrating, so find out which method works best if you have to reach her about something important.
Doctors have different likes and dislikes when it comes to getting back to patients. Does she prefer email, leaving a message with her nurse, or voice mail?