Term Paper on "Doctor Patient Relationship Impact in Medical Practice"

Term Paper 5 pages (1990 words) Sources: 1+

[EXCERPT] . . . .

Doctor/Patient Relationship Impact in Medical Practice

Patients always desire to have a competent physician that treats them with dignity and respect. Patients are always curious enough to hear and aware about the sickness they suffer from and the way it affects their lives. They desire that the physician should concentrate on their pain, physical uneasiness and behavioral problems. Physicians therefore are required to reevaluate, reaffirm and revitalize the relationship of physician and patients as well as its centrality. Sometimes, many patients demonstrate the qualities that cater to increase the physician and patient relationship. Studies have revealed prevalence of about five essential factors determining effective physician-patient relationship, such as "integrity, positivism, mutuality, constancy, and spirituality." (The Physician-Patient Relationship -- Perspectives after 40 Years of Family Practice) Reaffirmation of the personal and professional integrity by the individual physicians is considered as the most important strategy to establish effective patient and doctor relationship.

Integrity indicates total amount of honesty, trust, and reliability. It is imperative that each decision with regard to treatment necessitates the physician to first think about the welfare of the patients prior to any decision on the payment plan or the income of the physician. It is required that the care must supersede management. It has been the experience that there cannot be trust without integrity and without trust there can be no lasting doctor-patient relationship. The second element positivism implies a pervasive life stance that come out of one's entire being, boosts, sustains and imparts a remorseless vigor. Traditionally this has been an effective means of wining confidence of the patients, particularly amidst meager knowledge and paucity of effective pharmaceuticals. The physicians had to depend to a great extent on the old means of patient observation, arguing for reassurance, and the boosting support of his presence, all governed through the enforcing tools of comforting hands. (The Physician-Patient Relationship -- Perspectives after 40 Years of Family Practice)

However, presently, words have no equal force as instruments of relief as that had earlier. The patients presently rely more on the additional tests and seeks reassurance through them. They desire to have an additional X-ray test, one more venipuncture or endoscopy to prove the absence of disease. It is essential that the physicians must try to give out a feeling of optimism to create in that patient the same sense of optimism that the physician understands is a necessary element of the patient's cure. Studies have revealed that when it is possible to generate within the physician-patient relationship a pervasive and solid sense of positivism, not false assurance but a genuine undercurrent of optimism, such patients have demonstrated better responses than those surrounded by negative attitudes.

Thirdly, the element of mutuality implies a dedication of one's self. It is an inherent inclination to be frank, to risk and to be vulnerable. It implies communicating, actually listening to what another person has to reveal and it means infusing one's personhood into the internal relationship. When that is performed faithfully, the consequence is mutual understanding. It is only through such understanding that it is possible to talk to the hearts of others with the element of trust and clarity. However, mutuality does not always develop upon the breadth and depth, but we can try our best to transmit to each of our patients our sincere concern for them as being our fellow humans. (The Physician-Patient Relationship -- Perspectives after 40 Years of Family Practice)

Fourthly, Constancy is the crucial element in establishing good patient doctor relationship that indicates not only the period or duration, but also consistency, availability and reliability. It implies never discarding a patient; it indicates an inherent inclination to respond even when it necessitates self-sacrifice. It is essential to be available, listen, and be as totally present as possible. Constancy implies not leaving hope on a patient, irrespective of the fact that the case appears hopeless or when the patient is problematic. Consistency in the treatment and never giving up a patient is regarded as a significant facet of doctor-patient relationship. Finally, the physicians should have spiritual faith for improving such relationship. Often they confront with the taste of failures irrespective of the significance of faith in the physician and in oneself. At the moment when the doctor faces the obstacle irrespective of applying all his skills and power at such times it has become essential to depend on a power external to them.

Every patient happens to believe in something. The life of the patients has a spiritual dimension that differs according to their different beliefs and value systems. Doctors are required to regard such dimensions. These qualities of integrity, positivism, mutuality, constancy and spirituality permeate the physician-patient relationship and blend into a unified whole, the outcome becomes an overarching factor known as empathy. Empathy is not regarded as an affect like sympathy. It is considered as a skill that necessitates active listening, an articulate response and the imagination to visualize oneself at another's role. The real healing is best achieved in one-on-one basis. Each of the patients require somebody to share their worries and suffering, who can teach them that death is not the worst type of enemy and that healing can only occur inside the community. (The Physician-Patient Relationship -- Perspectives after 40 Years of Family Practice)

The problems in the relationship between patient and physician influence several aspects of medical care inclusive of diagnosis, adherence and use of medical services. The patients, those who were considered problematic by their doctors are more prone to demonstrate a higher level of incidence of psychiatric disorders like depression or somatoform disorder. The difficult patients are sometimes older and show the unexpected symptoms of chronic problems. The trend of somatizing of psychological distress into physical signs in a psychiatric population is enhanced by negative mood, several life stressors, daily struggles and insufficient coping. In a study, McGrady et al. could find that the patients with somatoform pain disorder reported more physical problems and had higher use of services.

The problems in the relationship of physician patient is attributed the patient for unsatisfactory outcomes in earlier days. Since the relationship involves two parties, the analysis of the relationship is to consider how each party understands the encounter. Particularly, the ability of the physician to convey fundamental caring features also influences use of medical services. It has been seen that patients perceiving their physicians as aloof or less caring may not approach for required medical assistance. Irrespective of the necessity to regard both patient and doctor as responsible, it is significant to stress that the medical appointment and in reality the entire relationship prevails to be advantageous to the patient. For this purpose particular sensitivity must be directed towards patient requirements and the conditions that attract patients to the medical encounter. (Patient-Physician Relationship and Service Utilization: Preliminary Findings)

Ever since the ancient times the role of the physicians was regarded to be fiduciary and in order to safeguard and promote health related interest of the patient it was regarded to be the important concern of doctor and self-interest was considered to be only as of a secondary concern. This humanistic perspective along with the level of respect for others, honesty and integrity, compassion, empathy, and professional superiority are at the base of the modern concept of medical professionalism. Even during the time of Plato a good doctor patient relationship was regarded as the base of medical practice. He described the insufficient doctor-patient relationship as the 'slave medicine' when the doctor is reluctant to provide the patient any description of his complaints and also never intended to ask for any. The physician-patient relation contrarily is a situation where the treatment of disease continues by deeply observing the things thoroughly from the initiation in a scientific way and takes the patient and family members into confidence while treatment. (Medical Professionalism in Time of Globalization: New Challenge for Medical Schools)

In the present day context also it is clear that the best clinical medicine is experienced when the scientific and technical features of care are focused in the background of a personal relation and trust between that of a physician and a patient. While the medical awareness clinical skills and clinical judgment have their own importance, the issue they utilize is even more significant. The doctor-patient relationship involves a mechanism where a joint decision is arrived at where in the patient is able to place his or her care in the hands of a particular physician and the physician upholds his or her obligation and capability to care for this patient. The doctor and patient relationship fosters the core professional values of physicians like duty, responsibility, compassion, truth, courtesy, altruism, honor and integrity, respect for others, and professional excellence forming the basic crux of medical professionalism. (Medical Professionalism in Time of Globalization: New Challenge for Medical Schools)

Studies have revealed trend of increasing interest of physicians and medical practitioners in fostering their efficacy in eliciting the past history of the patients and their concerns and inform… READ MORE

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