Doctor patients relationship

Patient doctor relationshipprof .Dr Elham Aljammas MAY2015l14

Physician’s Responsibilities

Freedom of choice
Responsibility to improve community
Responsibility to patient is paramount
Must support access to medical care for all people

Human dignity

Honesty
Responsibility to society
Confidentiality
Continued study

Patients rights

Right to give informed consent
Right to privacy
Right to be informed of advantages and potential risks of treatment
Right to refuse treatment
Right to confidentiality
Privileged communication


Patient expects from doctor....
A cure
Medication
To be listened to
Sympathy
Advice- he understands
The ‘answer’
A sick note
What they want (agenda)
Comfort
A chat
No harm
Professionalism & Respect
To be told what to do
To feel better
The truth

They feel ill physically

They feel ill mentally
They are lonely
They want time off work
Need advise
Don’t know who to turn to
Marital/family problems
Legal reasons
Why a patient goes to doctor..
Expectations


Doctor expects from patient...
Trust
Compliance to treatment
Agreement
The truth
Respect
They want to get better
To be listened to
To obey the ‘Rules’!

Doctor Patient Contacts

The nature of the relationship determines the success or otherwise of the contact

Communication and Diagnosis

Patients who feel at ease and who are encouraged to talk freely are more likely to disclose the real reason for consultion

Communication and Treatment

Advice ,reassurance and support from the doctor can have a significant effect on recovery
(The placebo effect)


clinical competence used to include the medical technical knowledge, physical examination, and medical problem solving .
while the Communication was missing from the list.
It is clear from the literature that better physician communication skills improve patient satisfaction and clinical outcomes and that good communication skill can be taught and learned

Patient controlled consultation

“You’re paid to do what I tell you!!”

The Paternalistic Approach

“If I’ve told you once I told you 1,000 times, stop smoking!!”

Paternalism

The traditional D-P relationship

Doctor Takes on role of “parent”

Patient submissive

Doctor centred consultation style:

Paternalistic - doctor is the expert and patient expected to cooperate

Tightly controlled interviewing style aimed at reaching an organic diagnosis.


Patient Centred consultation style

Less authoritarian - encourages patient to their own feelings and concerns

Open questioning, interested in psycho-social aspect of illness

Consultation Styles

It’s serious isn’t it doctor?

Patient centred clinical interview

Doctor –
history examination investigation
results in a differential diagnosis
Patient –
ideas, expectations, feelings,
results in an understanding of patients beliefs

Length of Consultation

Average 8 minutes

Makes patient centred consultation styles more difficult.

Goals of Communication Teaching and Learning

Doctors with good communication skills identify patients' problems more accurately

patients are more satisfied with their care and can better understand their problems, investigations, and treatment options

patients are more likely to adhere to treatment and to follow advice on behaviour change

In ConclusionCommunication techniques are a learned skill. Unfortunately, many health care providers discover this after an adverse event occurs. If this is the case in your facility, turn that negative experience into a positive teaching tool by asking these questions:
What can we learn from this?
How can we prevent a recurrence?
Is there anything we can do now to alleviate the situation?

Thank you