Dynamics of doctor-patient relationship: A cross-sectional study on concordance, trust, and patient enablement (original) (raw)

Evolution and changes in the physician-patient relationship

Colombia Medica

The idealized vision of the physician-patient relationship was characterized by patient trust and physician availability, in a long-term relationship in which physicians knew many things about their patients and their families, being the physician a part of the patient's community. Physician employers, pharmaceutical companies, and insurance companies have abruptly entered the once private relationship between physicians and patients, changing a true relationship into a simple encounter. The substitution of the generic terms physician and patient for provider and client mirrors the increased impersonality of the encounter based on the commercialization of medicine. The present review analyzes the situations, which have led to the progressive and unavoidable deterioration of the physician-patient relationship within a globalized society.

The Future of the Doctor-Patient Relationship- A Critique of Current Thinking

This review article seeks to highlight some contentious issues surrounding the transfer of medical knowledge and the ever evolving doctor-patient relationship. Using primarily articles and reports found using database searches, a review was conducted on several areas, namely; the doctor-patient relationship, trust, evidence based practise and power. From this analysis several conclusions were drawn. Most revealing is that trust is the key to facilitating good communication between doctors and ‘consumer’ patients. This trust can be improved by utilising web technology to improve health literacy. Doctors need to be aware of what type of consumers of information their patients are and suit interventions accordingly. Future implications are then discussed.

Doctor-patient interactions with respect to type of practice

International Journal Of Community Medicine And Public Health, 2020

The doctor-patient relationship is the core foundation for healing, care, establishment of trust and an essential part of modern-day medical ethics. In health care setting, trust and communication are labelled a tool for better patient care and patient satisfaction. 1 The doctor patient relationship consists of the six C's: choice, competence, communication, compassion, continuity and no conflict of interest. All of the six C's are required for maintenance of this relationship. 2 Since a long time, the doctor patient relationship has been of one to one communication. The last few decades have seen an exponential growth in the scientific component of the medical field which has led to a strain on this relationship. 3 In this fast-paced resource limited environment, doctor-patient relationship is lost. There is a need to analyse the growing distance in the physician patient relationship in terms of the management of chronic conditions. Here a substantial dependence on the patient and encouragement from the practitioner is needed to ensure compliance to their treatment regime and lifestyle modification. Considering the growing trend of patients wanting more information from their doctor in order to have a more active role in their health-care, ABSTRACT Background: The doctor-patient relationship is the core foundation for healing, care, establishment of trust and an essential part of modern-day medical ethics. The last few decades have seen an exponential growth in the scientific component of the medical field which has led to a strain on doctor-patient relationship. With the growing trend of patients wanting more information from their doctor in order to have a more active role in their health-care, active communication from the physician's end is needed. Present study aims to find out what doctors over various fields expect out of this relationship. Methods: A cross sectional prospective study was conducted among a total of 49 urban and rural doctors of various specialities in an urban area of Maharashtra using a pre-structured questionnaire. The statistical tools used to analyse the data was by using Microsoft excel software. Results: It was also noted that time spent with patients was less by the specialists as compared with other doctors for all aspects of consultation. On evaluating experience with the duration of consultation, we noted that doctors having more than 30 years of experience gave lesser time for all aspects of consultation as compared to those with lesser experience. A close range, between 45%-57% of all physicians, admitted to answering phone calls during consultations. Conclusions: It is imperative to study doctor-patient interactions since a better relationship results in a more satisfied patient with better treatment outcome.

Mandates of Trust in the Doctor-Patient Relationship

Qualitative Health Research, 2011

We examine the conditions for trust relationships between patients and physicians. A trust relationship is not normally negotiated explicitly, but we wanted to discuss it with both patients and physicians. We therefore relied on a combination of interviews and observations. Sixteen patients and 8 family physicians in Norway participated in the study. We found that trust relationships were negotiated implicitly. Physicians were authorized by patients to exercise their judgment as medical doctors to varying degrees. We called this phenomenon the patient's mandate of trust to the physician. A mandate of trust limited to specific complaints was adequate for many medical procedures, but more open mandates of trust seemed necessary to ensure effective and humane treatment for patients with more complex and diffuse illnesses. More open mandates of trust were given if the physician showed an early interest in the patient, was sensitive, gave time, built alliances, or bracketed normal behavior.

The patient–physician relationship: an account of the physician’s perspective

Israel Journal of Health Policy Research

Background: The issue of patient-physician relationships in general, and particularly the trust of patients in their primary care physician has gained much interest in academia and with practitioners in recent years. Most research on this important topic, however, focused on how patients view the relationship and not how the physicians see it. This research strives to bridge this gap, with the resolution of leading to an improved appreciation of this multifaceted relationship. Methods: A survey of 328 actively practicing physicians from all four health maintenance organizations (HMOs) in Israel resulted in a hierarchical formation of components, indicating both the relative as well as absolute importance of each component in the formation of the patient-physician relationship. The sample conducted was a convenience one. Methodologically, we used two different complementary methods of analysis, with the primary emphasis on the Analytic Hierarchical Processing (AHP), a unique and advanced statistical method. Results: The results provide a detailed picture of physicians' attitudes toward the patient-physician relationship. Research indicates that physicians tend to consider the relationship with the patient in a rather pragmatic manner. To date, this attitude was mostly referred to intuitively, without the required rigorous investigation provided by this paper. Specifically, the results indicate that physicians tend to consider the relationship with the patient in a rather pragmatic manner. Namely, while fairness, reliability, devotion, and serviceability received high scores from physicians, social interaction, friendship, familial, as well as appreciation received the lowest scores, indicating low priority for warmth and sociability in the trust relationship from the physician's perspective. The results showed good consistency between the AHP results and the ANOVA comparable analyses. Conclusions: In contrast to patients who traditionally stress the importance of interpersonal skills, physicians stress the significance of the technical expertise and knowledge of health providers, emphasizing the role of competence and performance. Physicians evaluate the relationship on the basis of their ability to solve problems through devotion, serviceability, reliability, and trustworthiness and disregard the "softer" interpersonal aspects such as caring, appreciation, and empathy that have been found to be important to their patients. This illustrates a mismatch in the important components of relationship building that can lead to a loss of trust, satisfaction, and repeat purchase.

The New Trends in Medicine and Trust

2018

Over the last years, the Russian National Health Care System has undergone a number of great changes. These reforms are motivated by the whole transformation of medicine as a social institute. As it showed by the numerous studies, under the process of the globalization and new technologies the clinical practice has been changed. The high technologies in medicine have incorporated new trends in practice and lead to use exactly hard evidence for diagnosis and treatment. But spending on new health technology increases healthcare costs. Now the main trend is the standardization of practice, that is relied on evidence-based medicine as it reduces costs. The great damage to the physician-patient relationship in these movements is that the patient is considered secondary, without attention to his individual characteristics and needs. It ignores the individuality and leads to the uniformity. It affects the doctor-patient relationship. As it well known, trust is a keystone of effective docto...

Trust in the Physician and in Medical Institutions. Modalities of Comprehension and Analysis

Postmodern Openings, 2014

The issue of trust in the medical profession, in medical institutions, and in the healthcare system, implicitly, has been brought to the scientists' attention lately, taking into account the erosion of trust, determined by the aggressive display in the media of medical personnel migration, of medical malpractice cases, of underfunding and bad management, of the high pressure on the system due to population ageing and to the increase in chronic disease incidence. Other explanations include the modifications in the attitudes, values, and expectations of the public concerning the healthcare system, the emergence of private health insurances and of private institutions, and the erosion of trust in State institutions because of incertitude and economic crises. This paper seeks to pinpoint, in the scientific literature, the definition of trust in the healthcare system, the determinants of trust in the patient-physicianinstitution-system relationship and the importance of social capital in these types of relationships, as well as the way in which the relationship between the patient and the actors within the medical system is created and influences the patient's quality of life in the context of chronic disease.