Doctor Patient

Relationship
Ayushi Roshan
Intern batch 2019 (C)

Date -3/9/24

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A strong doctor-patient relationship is
multi-faceted, built on trust,
communication, respect, and ethical
responsibility. By fostering this
relationship, doctors can provide better
care, and patients can have more
positive healthcare experiences, leading
to improved outcomes.

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The patient comes unbidden to a doctor and enters voluntarily into a contract
in which he agrees to follow the doctor's advice. By virtue of his technical
superiority knowledge and skill, the doctor exercises an authoritative role and
issues "orders" to his patient. Some individuals may not be prepared to
invest the doctor with full authority , this may lead to con ict between the
doctor and patient. The other qualities which mar the reputation of a doctor
are his greed for money, differential treatment between the rich and poor and
lack of a sympathetic and friendly attitude. . Patients who do not behave
according to the doctor's expectations are often labelled as "un-cooperative".
Besides technical competence, the doctor must know how to communicate
with the patient infact , a successful doctor is one who knows how well to
communicate with his patient .
In this regard, three levels of communication have been described.

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 (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 talk more freely to a folk
medical practitioner than with the modern physician. The
interpersonal relationships between villagers and folk
practitioners on one hand, and the villagers and the practitioners
of modern medicine on the other hand are considerably different.

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 (2) Communication on a cultural plane:
Secondly, 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. The reason why the indigenous and folk
systems of medicine are successful in the rural areas is
because they are part of the total way of life of the
people , treatment is based mostly on charity, and
payment to the physician may be in kind, and the
medicines are prepared from ordinary plants common
to the region. All these are appealing to the common
man. Against this background, the western system of
medicine is alien to the cultural patterns of the rural
folk. To be successful, the modern doctor should
couch his scientific advice in terms which fit an
already existing cultural pattern. Then there is a great
chance that this advice will be followed.

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For example, in communities where diseases and medicine are classified as hot and cold. it might be
helpful for the doctor not to challenge this belief openly. A mere statement to a patient that the medicine
is "hot" and will help to cure a "cold" disease may make for increased confidence. Anthropologists have
therefore stressed the importance of understanding the community as a whole, its general cultural
patterns and its social and political structure, and the native concepts of health and disease.

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(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 wide gap between the intellectual level of the practitioners of modern
medicine and the illiterate masses. In other words, there is an enormous "social distance" between the two
groups. A Successful doctor is one who reduces this distance and is able to communicate with his patient
freely and wins his confidence. A most important component of doctor-patient communication is humour. It
is the best icebreaker for the patient frozen by fear and anxiety.

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Key aspects of this relationship:

1. Trust

- Foundation of Care: Patients trust doctors with

their health and well-being. This trust allows them to
feel safe and con dent in sharing personal
information, adhering to medical advice, and
undergoing treatments.
- Consistency and Competence: Doctors must
demonstrate consistent competence in their eld. This
includes staying updated with medical advancements
and being honest about their limitations. A doctor's
reliability and skill build trust over time.
- Con dentiality: Protecting patient con dentiality
fosters trust. Patients need to know that sensitive
information shared with their doctor will be handled
with discretion and respect for their privacy.

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2. Communication

- Clear and Open Dialogue: Effective communication is

essential for understanding the patient's condition, concerns, and
expectations. This includes listening actively, asking clarifying
questions, and providing clear explanations of diagnoses,
treatments, and procedures.
- Empathy and Compassion: Communication should not just
be informative but also empathetic. Showing compassion helps
the patient feel heard and understood, which can improve their
overall experience and outcomes.
- Two-way Communication: Patients should feel empowered
to express their concerns, ask questions, and participate in
decision-making. Doctors must encourage this dialogue and
respond appropriately, making the patient an active participant in
their care.

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3. Respect

- Dignity and Autonomy: Every patient

should be treated with dignity, regardless
of their background, condition, or choices.
This includes respecting their autonomy to
make decisions about their care, even if
those decisions differ from the doctor's
recommendations.
- Cultural Competence: Respect also
involves understanding and
acknowledging cultural, social, and
religious factors that may in uence a
patient’s healthcare decisions. Doctors
should strive to provide culturally sensitive
care.

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4. Ethical Responsibility

- Bene cence and Non-male cence: Doctors have

an ethical duty to act in the patient’s best interest
(bene cence) and to avoid causing harm (non-
male cence). This requires balancing risks and bene ts
in treatment decisions.
- Informed Consent: Patients should be fully informed
about their diagnosis, treatment options, potential risks,
and outcomes. Doctors are ethically responsible for
ensuring that patients give consent willingly, without
coercion, and with a clear understanding of what they
are agreeing to.
- Justice: Treating all patients fairly and equitably,
regardless of their background, is a fundamental ethical
principle. Doctors must avoid biases and ensure that
care is accessible and equitable.

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5. Professionalism

- Boundaries: Maintaining professional

boundaries is essential to ensuring that the doctor-
patient relationship remains therapeutic. This
includes avoiding con icts of interest and
maintaining appropriate emotional distance while
still providing compassionate care.
- Accountability: Doctors must be accountable
for their actions and decisions, which involves
admitting mistakes when they occur and taking
steps to rectify them. Continuous self-re ection and
commitment to improvement are key aspects of
professionalism.

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 6. Shared Decision-Making

- Collaboration: The ideal doctor-

patient relationship is collaborative.
Doctors should guide patients in
understanding their condition and
options, but ultimately, decisions
should be made jointly, with the
patient’s values and preferences
being central.

- Empowerment: Shared
decision-making empowers patients
to take control of their health, which
can lead to better compliance with
treatment plans and improved
outcomes. Educating patients and
involving them in their care plans are
vital components of this aspect.

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 7. Compassionate Care
- Holistic Approach: Compassionate care goes beyond treating the disease; it involves considering
the patient's emotional, psychological, and social needs. This holistic approach helps create a more
supportive environment for healing.
- Patient-Centered Care: Focusing on the individual patient, rather than just their illness, ensures
that the care provided aligns with their personal needs and circumstances.

8. Continuity of Care
- Ongoing Relationship: A strong doctor-patient relationship often extends beyond a single visit or
treatment. Continuity of care allows for a deeper understanding of the patient’s history and fosters a
long-term, trusting relationship.
- Follow-up and Support: Following up on treatment outcomes and providing continuous support is
crucial to maintaining this relationship, ensuring that patients feel cared for even after they leave the
consultation room.

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 9. Patient Education
- Empowering Patients: Educating patients about their condition and treatment options helps
them make informed decisions. It also empowers them to take control of their health and manage
their conditions more effectively.
- Simpli cation of Information: Doctors must simplify complex medical information into
understandable terms, ensuring that patients fully grasp the details of their care.

10. Mutual Respect

- Value Differences: Mutual respect means recognizing that both the doctor and patient bring
valuable perspectives to the relationship. Doctors bring expertise, while patients provide insight into
their personal experiences and preferences. Valuing both aspects leads to better healthcare
outcomes.

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“Medicines can cure , but a good doctors inspirational words can give the
strength to fight from within “

Thank you

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