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Patient-Physician Relationship

For hundreds of years the question of correct relations between doctor and patient has always been very important. Evidence of this can be found in ancient writings and sayings of famous doctors, the founders of Medicine. The example can be the Hippocratic Oath. Hippocrates, who was a famous ancient Greek physician and is traditionally called “the father of medicine”. He wrote such famous works as “On the Physician” and famous “Hippocratic Oath”:

“I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement: To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art. I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion. But I will preserve the purity of my life and my arts. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal. If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.” (Boylan 2006)

The Oath of ancient physician demonstrates what high moral principles guided doctors of that time. This medical oath, which expresses the fundamental ethical principles of behavior of the doctor, is still used by doctors worldwide. It expresses the ethics of physician behavior, principles of conduct and relationship with the patient. Of course, now the emphasis has shifted somewhat, principles of medical practice has changed significantly, and the relationship between physicians and patients are now regulated even at the level of legislation. However, today no less popular is the theme of relationship of medical workers and patients, as well as the safety of medical practice, as at the heart of health care is the trust between patients and healthcare professionals. Therefore, fundamentally important is the creation of psychologically supportive environment for patients. ( Mahmud 2010)

The quality of care is the characteristic of the interaction between doctor and patient, due to professional qualifications, that is, his ability to perform therapeutic interventions, to reduce the risk of progression of the disease and the emergence of new pathological process, optimal use of health resources. High level of medical care in modern world makes very important for any doctor to ensure patient satisfaction of the quality of received help. To increase confidence in patient to medical staff, and his overall satisfaction with quality of care can be achieved by increasing the knowledge and practical skills of doctors in interpersonal communication between health workers and patients. Trusting atmosphere creates a genuine and stable relationship of the patient’s with medical practitioner, and the patient will be more disposed to contact and mutual cooperation with his doctor. With regard to the health, interpersonal communication is directed at changing the behavior of the relationship “doctor-patient”, “medical worker – the family of the patient,” patient – a patient with a similar disease, “etc. Such relationships involve dialogue and the establishment of such a relationship between patient and physician, which contribute to the discussion and solution of problems related to health. (Mahmud 2010)

Effective communication between health professionals and patients is largely determined by the patient’s ability and desire to actively participate in the subsequent course of treatment. This, in turn, can have a direct impact on the most fundamental change in approach to patient participation in treatment, increase his involvement in medical decisions, improve performance, or increase patients’ adherence. In practice, this means a change in the usual concept of “consent to treatment” on the concept of “commitment “- the strict observance of all doctor’s recommendations. If the first case, the relationship between doctor and patient provides a simple implementation by patient of medical instructions, and the model of “commitment” examines the treatment process as an informed, evidence-based cooperation between doctor and patient. Then a doctor gives the patient full and accurate information about his disease, condition, treatment options. According to experts, the consequence of such elations should be the emergence of a conscious patient adherence to treatment. (Speedling 1985)

The interaction can be complicated by the lack of clear rules for building relations between doctor and patient, and much depends on the ability of doctor to choose the right style of behavior. In general, it is possible to distinguish such main characteristics of the “doctor-patient” relationships :

  • Collaboration – Informed consent of the patient to an active participation in the treatment process can be defined as cooperation.
  • Empathy – the ability to experience a sense of his feelings for another.Such an element of empathy is critical in many interpersonal relationships and social attitudes.
  • Respect, which implies recognition of the value the patient as an individual and the importance of his worries.

Empathy, mutual understanding and respect are the key elements to the establishment of cooperation between doctor and patient.

 

References:

Boylan, M. (2006). “ Hippocrates”. Internet Encyclopedia of Philosophy. Retrieved from: http://www.iep.utm.edu/hippocra/
Mahmud A. (2010). Doctor-patient relationship. Pulse
Speedling Edward J. and Rose David N. (1985) “Building an effective doctor-patient relationship: From patient satisfaction to patient participation”. Social Science & Medicine, 21 (2): 115-120
Pandia S.K. (2001). “Doctor-patient relationship: the importance of the patient’s perceptions.” Journal of postgraduate medicine, 47 (1): 3-7