Doctor–patient relationship

The doctor–patient relationship is a central part of health care and the practice of medicine. The doctor–patient relationship forms one of the foundations of contemporary medical ethics. The doctor–patient relationship is a central part of health care and the practice of medicine. The doctor–patient relationship forms one of the foundations of contemporary medical ethics. A patient must have confidence in the competence of their physician and must feel that they can confide in him or her. For most physicians, the establishment of good rapport with a patient is important. Some medical specialties, such as psychiatry and family medicine, emphasize the physician–patient relationship more than others, such as pathology or radiology, which have very little contact with patients. The quality of the patient–physician relationship is important to both parties. The doctor and patient's values and perspectives about disease, life, and time available play a role in building up this relationship. A strong relationship between the doctor and patient will lead to frequent, quality information about the patient's disease and better health care for the patient and their family. Enhancing the accuracy of the diagnosis and increasing the patient's knowledge about the disease all come with a good relationship between the doctor and the patient. Where such a relationship is poor the physician's ability to make a full assessment is compromised and the patient is more likely to distrust the diagnosis and proposed treatment, causing decreased compliance to actually follow the medical advice which results in bad health outcomes. In these circumstances and also in cases where there is genuine divergence of medical opinions, a second opinion from another physician may be sought or the patient may choose to go to another physician that they trust more. Additionally, the benefits of any placebo effect are also based upon the patient's subjective assessment (conscious or unconscious) of the physician's credibility and skills. Michael and Enid Balint together pioneered the study of the physician patient relationship in the UK. Michael Balint's 'The Doctor, His Patient and the Illness' (1957) outlined several case histories in detail and became a seminal text. Their work is continued by the Balint Society, The International Balint Federation and other national Balint societies in other countries. It is one of the most influential works on the topic of doctor-patient relationships. In addition, a Canadian physician known as Sir William Osler was known as one of the 'Big Four' professors at the time that the Johns Hopkins Hospital was first founded. At the Johns Hopkins Hospital, Osler had invented the world's first medical residency system. In terms of efficacy (i.e. the outcome of treatment), the doctor–patient relationship seems to have a 'small, but statistically significant impact on healthcare outcomes'. However, due to a relatively small sample size and a minimally effective test, researchers concluded additional research on this topic is necessary. Recognizing that patients receive the best care when they work in partnership with doctors, the UK General Medical Council issued guidance for patients 'What to expect from your doctor' in April 2013.