Top 6 benefits of solid doctor-patient relations
Table of Contents
Introduction to doctor-patient relations
“The good physician treats the disease; the great physician treats the patient who has the disease.”
— Sir William Osler, FRS, FRCP (Canadian physician)
Have you ever wondered what makes doctor-patient relations integral to present-day healthcare? Do you have a good rapport with your physician? In modern times, doctor-patient relations have evolved drastically to impact patient outcomes. About two decades earlier, doctor-patient relations were different. The doctor would simply attend to the patient seeking help and the patient would comply with the mode of treatment suggested without delving much into the details. This has undergone a major transition and the modern-day healthcare scenario is to develop mutual trust between doctor and the patient to address healthcare concerns thoroughly.
Ideal provider-patient relations should be such that the patient can confide in the doctor’s ability. The doctor should be able to address all the concerns that a patient has and encourage them to make a decision that aligns with that of the doctor for a positive patient experience. The opposite is true as well. Lack of communication and trust may impede physician-patient relationships which impact patient outcomes in a negative manner.
Models of doctor-patient relations
In 1956, Szasz and Hollender gave three basic models of the doctor-patient relationship. These are –
Active Passive Model
This is the oldest model of doctor-patient relations that entails that the doctor holds the power over all the decisions for the patient. In this model, the patient is considered inanimate and the doctor is responsible for formulating all decisions that the patient must accept. The patient remains passive and has no control over medical decisions. This model is appropriate during a medical emergency where the patient is unconscious or an instant decision is required to treat a chronic illness.
Guidance -Cooperation Model
The guidance-cooperation model finds the most relevance in the healthcare system. The doctor holds the position of decision-making because of the medical knowledge he possesses. This model aligns with the ‘doctor knows the best’ theory. The doctor is responsible for making the appropriate treatment decisions that hold the best interest of the patient. The patient is expected to comply and follow the doctor’s recommendations.
Mutual Participation Model
The third model of doctor-patient relations is the mutual participation model which is based on the shared responsibility for decision-making. The doctor and the patient are both supportive and respectful of each other. The patient is involved in making the decision related to the treatment while the doctor’s role is to suggest the best treatment options available.
This model gives equal power to the doctor and the patient. They are both interdependent and plan the course of treatment together. The objective of this model is to fulfill the patient’s medical goals with the help of mutual participation. This model is beneficial in situations where the patient is suffering from a chronic illness like rheumatoid arthritis. In this scenario, the doctor and the patient should have open communication to decide the course of the most effective treatment plan and modify it if needed.
The evolution of doctor-patient relations
Prior to the early 1900s, the physician-patient relationships were rooted in fiduciary where the doctor was focused more on refining their manners as most illnesses were incurable or treatments had a limited effect. After the French revolution, science made incredible progress and the relationship drifted toward providing the cure and not the ‘care’.
However, in today’s modern healthcare system, doctor-patient relations found a renewed interest in providing the necessary ‘care’ to create meaningful experiences.
Let us see how the social and political conditions impacted this relationship through the various epochs.
Ancient Egypt (4000 to 1000 B.C.)
According to Edelstein, the physician-patient relationship was rooted in mysticism and theology. Priests were the early doctors who seemed to cure patients through magic. It was an excellent example of the active-passive model. There were barely any scientific advances and an unsophisticated approach was followed.
Greek enlightenment (600 to 100 B.C.)
The Greeks relied on a rational approach to medicine and there existed some degree of mutual cooperation in doctor-patient relations. Under the Hippocratic Oath, the ‘Bill of Rights’ was established for the patients. It entailed rules of conduct for doctors to act in the interests of patients.
Medieval Europe (1200 to 1600 A.D.)
The Roman empire was overthrown and supernatural beliefs were back. It led to the revival of magic and doctors were ranked high in society. The active-passive model was followed widely and patients were considered inanimate objects.
The French revolution (18th century)
The Renaissance inspired the search for science, art, equality, and dignity that led to the French revolution. This led to the adoption of the guidance-cooperation model that aimed to cater to patients with trust and care.
1700 to the present day
During the early 18th century, the doctors were outnumbered and they mainly catered to the affluent. The model of illness followed was based on the individual symptoms of the patient. Fast forward to the late 18th century, hospitals began to emerge to cater to the underprivileged population.
The new model of illness dictated that the symptom was not the illness but merely an indicator of a particular problem. Even though the active-passive model was prevalent, the doctor would give a thorough diagnosis by examining the patient’s body and using the medical expertise to recommend a suitable treatment. The patient was passive and gave consent to the treatment plan laid out by the doctor.
Components of the doctor-patient relationship
- Instrumental – The instrumental component of the doctor-patient relationship involves the technical competence of the physician in performing diagnostic tests and physical examinations.
- Expressive – The expressive component entails the ‘expressive’ components of the doctor-patient relationship – how the doctor treats the patient, the communication style, the elements of warmth and care, etc.
Advantages of positive doctor-patient relations
Having a good rapport between the doctor and the patient is key to the right prognosis. It offers several advantages which are enlisted below –
- positive doctor-patient relations lay the foundation for effective communication between both of them. It ensures that the flow of information is easy and which is vital for a patient’s speedy recovery.
- It opens up the channel for two-way communication and the doctor can seamlessly gather required vital information about the patient to make an accurate diagnosis. This helps in devising an appropriate treatment plan.
- When the patients are compatible with the doctor, they can easily comply with care instructions. This helps in the speedy recovery of the patients.
- When doctors and patients collaborate in shared decision-making, it shows that patients trust completely in the doctor’s ability. This encourages loyalty and the doctor can retain a satisfied patient once the treatment is over.
How to foster doctor-patient relations?
The doctor-patient relations comprise essential elements such as trust, compatibility, communication and competence. When a physician knows the patient and the medical history, he can offer personalized health recommendations to offer better disease prevention and control. Building a solid doctor-patient relationship is a two-way street. It requires faith in the doctor’s competence and the doctor’s trust in the patient’s beliefs for improvement. According to Gordon and Beresin, poor doctor-patient relations lead to negative outcomes. It also influences if the patient will return to the same physician or not. Therefore, this relationship is at the core of quality medical care. Below are enlisted some of the tips that can improve doctor-patient relationships and patient satisfaction rates –
- Patient centeredness
A report by the Council of Accountable Physician Practices (CAPP) showed that the patient-provider relationship is crucial to quality care. In order to understand the suffering of the patient, the doctor must show empathy and mindfulness of the patient’s symptoms to ease the suffering. The patient should be considered an important entity and the doctor must explore the patient’s side of the story as well as health history to give the right prognosis.
- Shared decision-making
The doctor-patient relationship should have mutual trust so that they follow a shared decision-making approach. The doctor should provide recommendations and the opportunity to let the patient choose a relevant treatment option.
- Good two-way communication
The communication should be open and two-way between the doctor and the patient. The doctor should listen attentively and look for cues that give insights into patient concerns. Ideally, the doctor should get rid of all distractions while attending to the patient to establish a meaningful relationship. If the patient feels rushed, he should let the doctor know.
- Be available
As per a 2018 study that reviewed 1319 visits to 56 physicians at the UC Davis Family Medicine Clinic, it was highlighted that 68% of patients visited with a specific request and doctors fulfilled those requests about 85% of the time. Each time they denied a request, the patient satisfaction rates dropped by 20 points. Even though it is not possible for the provider to cater to every single request, there are ways to be available and improve patient satisfaction rates. One great way is to use a patient engagement software that can drastically reduce the paperwork and administrative work so that you can spend that time with your patients. It can also help reduce patient no-shows and help foster a great doctor-patient relationship.
- Focus on the positives
Generally, patients are more responsive to the positive approach or tactics. Instead of sounding negative with scare tactics, try to address the patient’s concerns and fears in a positive manner.
- Respect for patient’s wishes
The doctor should also keep cultural factors in mind while attending to a patient. The patient may reject a certain medication or treatment due to religious beliefs. The doctor must display respect for the patient’s informed consent while conveying the implications of that decision as well.
Conclusion
The best provider-patient relationship involves an alliance between both parties where the information is dispensed in a supportive and positive manner. Having a healthy relationship can alter health outcomes and improve patient care. However, physicians must also recognize when the relationship is failing. They can often get prone to burnout or exhaustion due to increased workload.
According to a survey conducted by Statista, about 33% of physicians in the US spend around 17 to 24 minutes with their patients and about half of their overall time on administrative work. Having a technology-powered software solution such as patient engagement software can help optimize the provider-patient relationship. Emitrr is a complete patient engagement solution that can boost patient satisfaction rates and significantly reduce the time to develop a solid doctor-patient bond.
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