Why the patient/provider relationship is key to better hospital care
Feb 15, Patients and providers need to have a strong relationship to boost outcomes. Patients are in a vulnerable position, with the balance of power often tipped in favor of the healthcare provider. This is why open two-way communication, trust, . Nov 27, Healthcare professionals must tap many strategies to help build a positive patient -provider relationship, helping them to succeed in.
But objective and theoretical bases for genuine concern remain. This article examines the foundations and features of the doctor—patient relationship, and how it may be affected by managed care. A robust science of the doctor—patient encounter and relationship can guide decision making in health care plans.
We know much about the average doctor's skills and knowledge in this area, and how to teach doctors to relate more effectively and efficiently. We describe problems that exist and are said to exist, we promulgate principles for safeguarding what is good and improving that which requires remediation, and we finish with a brief discussion of practical ways that the doctor—patient relationship can be enhanced in managed care.
The medical interview is the major medium of health care. Most of the medical encounter is spent in discussion between practitioner and patient. The interview has three functions and 14 structural elements Table 1. For example, a patient who does not trust or like the practitioner will not disclose complete information efficiently.
A patient who is anxious will not comprehend information clearly. The relationship therefore directly determines the quality and completeness of information elicited and understood. It is the major influence on practitioner and patient satisfaction and thereby contributes to practice maintenance and prevention of practitioner burnout and turnover, and is the major determinant of compliance. Effective use gives patients a sense that they have been heard and allowed to express their major concerns, 17 as well as respect, 18 caring, 19 empathy, self-disclosure, positive regard, congruence, and understanding, 20 and allows patients to express and reflect their feelings 21 and relate their stories in their own words.
Other aspects important to the relationship include eliciting patients' own explanations of their illness, 2324 giving patients information, 2526 and involving patients in developing a treatment plan.
The accessibility of personnel, both administrative and clinical, and their courtesy level, provide a sense that patients are important and respected, as do reasonable waiting times and attention to personal comfort. The availability of covering nurses and doctors contributes to a sense of security.
Reminders and user-friendly educational materials create an atmosphere of caring and concern. Organizations can promote a patient-centered culture, 29 or one that is profit- or physician-centered, with consequences for individual doctor—patient relationships.
Organizations as well as whole health care systems can promote continuity in clinical relationships, which in turn affects the strength of in those relationships. For instance, a market-based system with health insurance linked to employers' whims, with competitive provider networks and frequent mergers and acquisitions, thwarts long-term relationships.
A health plan that includes the spectrum of outpatient and inpatient, acute and chronic services has an opportunity to promote continuity across care settings.
The Doctor–Patient Relationship
The competition to enroll patients is often characterized by a combination of exaggerated promises and efforts to deliver less.
Patients may arrive at the doctor's office expecting all their needs to be met in the way they themselves expect and define. They discover instead that the employer's negotiator defines their needs and the managed care company has communicated them in very fine or incomprehensible print.
Primary care doctors thus become the bearers of the bad news, and are seen as closing gates to the patient's wishes and needs. When this happens, an immediate and enduring barrier to a trust-based patient-doctor relationship is created. The doctor—patient relationship is critical for vulnerable patients as they experience a heightened reliance on the physician's competence, skills, and good will.
The relationship need not involve a difference in power but usually does, 30 especially to the degree the patient is vulnerable or the physician is autocratic. This is called shared decision making.
If you feel like your doctor is pushing you into accepting a specific treatment plan, this is a warning sign. When it comes to decisions large and small about your healthcare, your doctor should be your partner in the decision-making process. Yet, delivering such news can and should be done honestly and with empathy. A doctor who is cold, arrogant, impatient, rushed, or who otherwise demonstrates a poor bedside manner can quickly lose your trust and leave you feeling unsure, anxious, frightened, angry, and alone.
Maintaining Healthy Patient-Provider Relationships
Perhaps he or she is very direct, talks faster than you can follow, or has a demeanor that makes you anxious or uncomfortable. Use your first visit as a test. For example, a doctor may strongly encourage the use of a particular medication that has side effects a patient considers unacceptable. Or, because of religious beliefs, a patient may refuse a blood transfusion that could improve or prolong their life. As a patient, your doctor is ethically obligated to consider your wishes about your healthcare.
One or two lawsuits may not be cause for panic, but, if the physician or hospital has a history of lawsuits, this is a problem sign. Board certification through the American Board of Physician Specialties ABPS means the physician has earned a four-year medical degree from a qualified medical school, is licensed to practice medicine by a state medical board, has completed an accredited residency program of at least years, has passed exams administered by the ABPS, and participates in continuing education.
In particular, ask about drug reps and medical device manufacturers—who often influence doctors and physician practices to use particular drugs, often by wooing them with catered lunches and other perks. If your doctor sends you home with a bag of drug samples, this is a telling sign. Most clinics, hospitals, and medical practices have transitioned or are in the process of transitioning to electronic health records EHR systems, which help your doctor track your medical history and exchange information with specialists, among other functions.
Many of these systems also feature secure patient portals, through which patients can book and track doctor appointments, view medical records and lab results, send messages to their doctors, and request prescription refills. While there are drawbacks to EHR systems a common complaint is reduced face-time with doctorsthese systems also have their advantages. Fulton County Medical Center: Your Trusted Healthcare Provider Our Fulton County, PA medical center has been providing comprehensive care in a patient-centered environment for more than 65 years.
From diagnostic services to cardiopulmonary careto nutrition counselingFulton County Medical Center offers a full spectrum of services to patients of all ages.
As a leading healthcare provider in the area, our focus is on compassionate care and community health.