Doctor and Patient Relationship

By

Elmi Omar Haji Elmi

Outline

 What is doctor-patient relationship

 Ways to improve DPR
 Effective Doctor-Patient Communication
 Problems in Doctor-Patient Communication
 Effective Doctor-Patient Communication
Impact on Outcomes
What is doctor-patient relationship
 Doctor-patient relationship is an important
bond between patients and doctors in which
complex social factors are implicated.

 The patient comes unbidden to a doctor and

enters voluntarily into a contact in which he
agrees to follow the doctor’s advice. Thereby,
the doctor exercises an authoritative role and
issues “orders” to his patient due to his
technical superiority, knowledge, and skill.
Ways to improve doctor-patient
relationship
 To improve doctor-patient
relationship the role of doctors is the
prime factor and this can be possible
by proper communication with his
patient.
 In this regard, three level of
communication have been described:
1- communication on an
emotional plane
 The doctor must give a sympathetic ear
to the complaints made by the patient
and his relatives. This is necessary to
establish a quick rapport.
 The reason why folk medicine is
successful is because the patient and his
relatives feel they can talk more freely
to a folk medical practitioners than with
the modern physician.
Cont…
 The interpersonal relationships
between villagers and folk
practitioners on one hand, and the
villagers and the practitioners of
modern medicine one the other hand
are considerably different.
2-Communication on a cultural
plane
 The doctor should be aware of the
general concepts of culture and social
organization of the community with
which he is dealing.

 This helps to acquire certain “flexibility”

in his dealings with patients.
Cont…
 To be successful, the modern doctor
should couch his scientific advice in
terms which fit an already existing
cultural pattern.
 E.g., in communities where disease
and medicine are classified as hot and
cold, it might be helpful for the doctor
not to challenge this belief openly.
3- communication on an
intellectual plane
 Practitioners of modern medicine
come from well-to-do-families. By
their education and training, they
tend to be sophisticated.
 This leaves a side gap between the
intellectual level of the practitioners
of modern medicine and the illiterate
masses (social distance).
Cont…
 A successful doctor is one who reduces
this distance and is able to communicate
with his patient freely and wins his
confidence.
 The doctor who is able to communicate
with his patient on these three planes is
bound give maximum psychological
satisfaction to his patients
Why learn effective doctor- patient
communication?
To:
 Enhance the therapeutic nature of the medical
encounter
Manage problems in doctor-patient communications
 Improve outcomes of care through:
Mastering a Model of Communications
Function of the medical interview
Structure of the medical interview
 Knowing how to improve ones skills over time
 Effective Doctor-Patient
Communication Why?
 Most time spent between practitioner and
patient
 The most prevalent behavior in a
clinician’s lifetime
 Diagnose and treat disease
 Facilitate healing
 Establish and maintain a therapeutic
relationship
 Offer information and educate
 Therapeutic Nature of the
Medical Encounter: CARE
 Help patients Cope with stress and illness or with
bad news
 Activate patients’ participation in self care and well
being
 Increase patients’ sense of accountability,
 Responsibility, self esteem and confidence

 • Empower patients’ own decision making about

their health
 Problems in Doctor-Patient
Communication
 45% of patients’ concerns are not elicited
 50% of psychosocial and psychiatric problems
are missed
 In 50% of visits, patient and physician do not
agree on the main presenting problem
 Patients’ most common complaint is the lack of
information provided by physicians
 Majority of malpractice suits arise from
communication errors; not incompetence
Effective Doctor-Patient
Communication Impact on Outcomes
Interview-related factors have documented impact
on outcomes of care such as
Symptom resolution (e.g., BP, sugar)
Pain control
Physiological responses
Daily functioning
Emotional health (e.g., decreased distress,
anxiety)
Treatment adherence
Patient and provider satisfaction with the
encounter and with overall care
THANK YOU