Patient physician relationship

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Patient physician relationship

Since the primordial times, it has been known that the physician and patient amalgamation is an important aspect for maintaining health and well-being of an individual. To draw the maximum use of this relationship, the patient needs to timely present their medical problems to a physician to explain their problem in the best way possible and most importantly a respectful alliance between the two needs to be maintained.

Relationship goals

The physician-patient relationship is of primary importance in the overall health care delivery model. It is a unique relationship which depends on trust and confidence between the parties for the provision of care. Physicians enter into a physician-patient relationship with a commitment to provide their patients with quality service. However, when circumstances affect the physician’s ability to achieve this, the physician may decide to end the physician-patient relationship. In some cases, it may be the patient who decides to end the physician-patient relationship.

Trust is basis of any relationship and so for efficient bonding it is equally important meaning that the physician should not betray his patient whose care he has undertaken. The WMA’s International Code of Medical Ethics implies that the only reason for ending a physician-patient relationship is if the patient requires another physician with different skills: “A physician shall owe his/her patients complete loyalty and all the scientific resources available to him/her. Whenever an examination or treatment is beyond the physician’s capacity, he/she should consult with or refer to another physician who has the necessary ability.” However, there are many other reasons for a physician wanting to terminate a relationship with a patient, for example, the physician’s moving or stopping practice, the patient’s refusal or inability to pay for the physician’s services, dislike of the patient and the physician for each other, the patient’s refusal to comply with the physician’s recommendations, etc. The reasons may be entirely legitimate, or they may be unethical.

Creating the relationship

The physician-patient relationship is created by mutual consent that may be express or implied. For example, an unconscious accident victim who is brought to the emergency room is not “knowingly” seeking the services of a physician. Yet, the relationship is created when the ER doctor begins treatment. Mutual consent is implied in this case.

Simply making an appointment for the first time with a physician is not usually sufficient to create the relationship, even though there may be mutual consent evidenced by the patient making the appointment and the physician scheduling it. Generally, the duties and obligations created by the relationship do not arise until the physician affirmatively undertakes to diagnose and treat the patient, or affirmatively participates in the diagnosis and treatment. However, an informal opinion (a curbside consultation) offered to a colleague regarding patient care does not create a physician-patient relationship in most jurisdictions. A physician may decline to accept a patient for any reason that is not illegal. For example, a physician may not refuse to accept a patient based upon race, gender, national origin, religion, or any other illegal discriminatory reason.

Patients also have a duty to communicate and cooperate with the physician by:

  • providing a complete medical history,
  • requesting information or clarification about their treatment,
  • following agreed upon treatment plans,
  • keeping appointments,
  • disclosing whether previously agreed upon treatment plans are being followed,
  • meeting financial obligations,
  • discussing financial hardships with the physician, and
  • using medical resources judiciously

In the same way, Physicians role is not restricted to just provide the necessary treatments but also by helping their patients' advocate and endorsing the below rights:

Right to information:

Patient has the right to procure information from the physician plus discuss benefits, risks and costs of appropriate treatment options. The physician should guide the patient to achieve the necessary course of action.

Right to decision making:

Patient has the right to take decision about the health care suggested by their physician. They can also accept or reject the suggestion according to their convenience.

Right to dignity and respect:

Patient has the right to respect, dignity, respect, timely attention and courtesy to their needs.

Right to confidentiality:

Physician should has unveiled the confidential information without the patient's will, until or unless to safeguard the individual or public interest or law obligation.

Right to continuity:

Physician can entail to cooperate in rendering medical care with the other healthcare providers treating the patients. As long as further treatment is medically indicated, without giving the patient reasonable assistance and sufficient opportunity to make alternative arrangements for care, the physician may not drop out the treatment.

Right to adequate healthcare available:

No patient should be under- privileged just because of the society's inability to render heath care resources. In conducting with third parties, Physicians should advocate for patients when required.

The managed care plans:

To curb the unsatisfactory performance in providers and patient encounters, proper training should be imparted to the doctors to deal with grueling patients, about the frequent aspects of life alteration like response to ill condition, in acknowledging the repressed psychological problems that remain a main cause of seeking medical care, in settling and handling strenuous conditions like breaking bad news. Thus, such skills can be obtained from courses by many places as the American Academy on Physician and Patient (AAPP), the Bager Institute, the Northwest Institute etc. There is a need for the patients to regiment their outlook towards care, to question, to negotiate and share feelings. The agenda of the plan can urge a patient- and member-centered culture. The clinicians and the physicians are emboldening to lay their patient's good first, ahead of their advantage, politics (e.g. Hesitation to confess mistakes) or personnel satisfaction.

The major obstacle to good physician-patient communication is differences of language. If the physician and the patient do not speak the same language, an interpreter will be required. Unfortunately, in many settings there are no qualified interpreters and the physician must seek out the best available person for the task.

Thus, the physician-patient relationship creates more than a special bond between physician and patient. Physicians are regarded as god in the eye of patients, so it becomes physician's duty to be honest to their profession and to provide information and education to their patients about treatment alternatives and the course of care, especially expectations for surgical outcomes. Physicians should not hesitate to discuss the risks of surgery and possible complications. He must be kind and compassionate, which creates realistic expectations for patient, increase his satisfaction, and also reduces the risk of malpractice claims. It serves as the foundation for the entire legal and ethical framework within which a physician works. Subsequent tutorials cover the legal and ethical obligations imposed upon physicians when the physician-patient relationship exists.

The minimum average time for the doctor visits should be depicted in the plans. There should be enough time together for the doctors or patients, as lack of this time is a problem faced commonly. The patient complaints regarding visit time may be a competent patient-centered indicator of potential trouble in doctor–patient relationships as time of visit varies by type of visit, type of doctor, and complexity of the patient.

Also, the plans can promote contemplation of psycho social issues in all forms of patient care. This can be done by an organization continuing education, promotional materials, patient-directed training and quality improvement attempts to promote this aspect of patient care. Thus, debates about these areas between doctors and patients will be empowered, the patient will be more contented and non-essential visits as to emergency department for panic attacks, may be lowered.

Exploratory, WMA’s International Code of Medical Ethics, Patient-physician relationship, Informative article
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