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Doctors, Improve Your Relationships With Your Patients

Harold Mandel's picture
Healthcare with a heart

Technical skills aren't the only thing that makes for a good doctor. Making patients happy with their healthcare also means having a good doctor-patient relationship.


It has been becoming clear that what constitutes good medical care has become a very contentious issue in the United States these days. The ramifications of increased government interests in the provision of health care, as seen with Obamacare, has been making the headlines daily. Tempers over the government wanting to completely control health care become even more heated when citizens are hit with swift, cursory civil court orders by psychiatrists and their personal judges demanding unwanted and clearly generally unnecessary intervention.

This is not what makes patients happy, and clearly happiness is associated with healthy states of well being in body and mind. Research shows patients are happiest when they have good relationships with their doctors, and clearly any such good relationship only becomes possible when doctors are sensitive to the feelings of their patients and offer them the opportunity to take an active role in their own health care management.

Research which has been done dealing with the question of how improved continuity of primary care affects the clinician-patient relationship, which is so vital to good patient outcomes, has been reviewed in the Journal of Internal Medicine. There have been concerns that recent changes in the delivery of health care may lower continuity with the patient’s primary care provider (PCP). Reduced PCP continuity has been found to potentially have a significant influence on undermining the quality of patient–provider communication. It is felt that by improving continuity with the assigned PCP, there exists the potential to improve patient–provider communication.

The doctor–patient relationship is the primary keystone of care at this time, as it has been for a long time, as conveyed in a discussion of the doctor–patient relationship by the National Institutes of Health . Patient compliance free of will can only be anticipated if patients like their doctors. And outcomes of treatment can only be anticipated to be positive in all dimensions, including body and mind, if the happiness of patients is nurtured by giving them free will in choosing their providers and a lot to say about their treatment plans.

Ever since the time of Hippocrates there has been a great deal of philosophical and literary attention paid to the vital importance of the relationship between doctors and their patients. This relationship begins with the medical interview which is the major medium of health care when done properly. For the most part this medical encounter is spent in a discussion which takes place between the practitioner and patient. Patients appreciate efforts by their doctors to develop and maintain a therapeutic relationship with them while they are gathering information and communicating information.

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Patient satisfaction here is a major determinant in compliance and outcomes. It has consistently been observed that patients who are shown respect and who are invited to take an active role in the medical encounter and in their actual care do much better biologically and in their quality of life. There are also less lawsuits and threats of lawsuits against doctors when they take the time to show real respect for the freedom of their patients to have an active say about their own care.

There is a new trend in American health care which is known as the patient-centered medical home, as written about by the University of Iowa. In this new approach to patient care a primary-care physician orchestrates the entire effort. It revolves around a team of medical and health professionals who, working together, treat the patient. A primary goal in this setting is for the team to know everything about the patient, no matter how disparate the symptoms are. It s emphasized that the patient should be treated in a holistic way.

There has been an increase in the popularity of patient-centered medical homes (PCMH) ever since the National Committee on Quality Assurance recognized them about five years ago. At this time there are more than 1,500 practices like this which are recognized. Nevertheless, when good doctor-patient relations lapse there remain questions about the effectiveness of even this innovative new mode of medical intervention.

It has been consistently found that a regular open channel of communication between the patient and the primary physician is critical to success. Dr David Katz, a corresponding author of this study, points out that during this time of intense changes in health care, we can’t lose sight of the vital importance of the doctor-patient relationship. Dr Katz encourages better training of physicians dealing with how to engage patients in shared decision processes while giving their patients more instruction on how to deal effectively with a primary-care visit. EmaxHealth reporter Tim Boyer, PhD discusses how good physician-patient relations can lead to confessions which are good for your health.

It has been my observation that the patient-doctor relationship is generally the single most important determining factor in not just patient compliance, but also in outcomes. Arrogant and indifferent doctors, as we consistently see with psychiatrists, actually create illnesses which lead to unusual pain and suffering, wasted lives, and the premature deaths of their patients. On the other hand, warm and compassionate physicians who show a deep respect for the happiness and freedom of their patients, as we often see with family doctors, internists, pediatricians and other primary health care providers, consistently appears to help promote not just patient compliance, but also actual healing.

Doctors exhibiting empathy for patients to help with good patient outcomes is of vital importance says Dr Wulffson, MD in his earlier story, "Does bedside manner make a difference in patient outcome?" In view of the widening interface between health care, the law and economics, what we are actually often seeing is the creation of sick people who are more prone to becoming criminals who are struggling to survive in poverty by bad doctors, such as psychiatrists, while the other doctors are working hard to try to help create healthy, productive and law abiding people who prosper in all they do in life.