This month’s newsletter is not about asthma or allergy. I wanted to pen down some of my thoughts on another general, but important, topic and that is “Doctor-Patient Relationship”

Any relationship is based on a set of certain duties and expectations. Doctor-patient relationship is no different. A certain code of conduct is expected of the doctor and the patient too must realize his duties. Relationships can be a source of great joy and satisfaction and soured relationships can cause untold misery and heartburn.

When a patient goes to a doctor, what is a he looking for? First and foremost, it is competence. That is a must; but it is not enough. He is also looking for someone who is willing to listen, understand the problem and offer a solution. Someone who can empathize. Who can explain things in simple language and guide as to what can be expected. Who can support the patient through the journey from being unwell to being well again. Are these expectations of the patient unreasonable? No, they are not.

The biggest grouse patients have from doctors is that they don’t listen and they don’t give enough time to the patients. Data from Mayo Clinic shows that an average doctor patient encounter is interrupted by the doctor within 18 seconds of the patient’s account of his problem. 18 seconds !! Surely a doctor can be more patient. That same study also showed that an average patient, if allowed to say what he has to say uninterrupted, finishes his story in 90 seconds. Surely, that much time can be granted.

Another grouse patients have of doctors is that they are unfeeling and callous. Doctors are dealing, day in and day out with problems, diseases and death. To be able to function they have to detach themselves, to a certain extent, from negativity. Yes, doctors should not be so detached that they do not feel the pain of the patients.

How can doctors do better?

1. Give more time to the patients.
2. Listen to them attentively
3. Detachment if fine but have empathy for the patient
4. Put yourself in the patient’s shoes to see their perspective
5. Be there for the patients need. Attend their needs on the phone. Two minutes of your time means a lot to the patient.
6. Be encouraging and supportive.

How can patients do better?

• Doctors are always very busy; they always have more things to attend to than the time available. Respect his time. Don’t call at odd hours for minor or non urgent issues.
• When meeting a doctor, come prepared for the info that the doctor will require. Be concise. Don’t ramble. Nothing is more irritating for the doctor than a patient who just goes on and on. It a good idea to make notes of the important things to tell and ask the doctor while waiting in the waiting room. This makes the consult very effective.
• Trust the doctor. Have faith in him

There are certain patients who are quite well read and well informed. That is very good. But sometimes they form opinions and half baked ideas and only want the doctor to ratify them. If the doctors professional opinion does not match their’s, they go to another doctor. The other extreme are patients who just do not want to assume any responsibility of their disease or treatment. They don’t want to listen to the doctor; they never know the names of the medicines they are taking. Their constant refrain is “just make me ok doc “

The doctor patient relationship has changed with time and changing social values. Earlier it used to be very paternalistic- “The doctor knows best.” or “Am I the doctor or are you” Now patients are well informed and want to actively participate in the decision making process. This is a very good change. Doctors, who engage with the patients, explain things and encourage patients to ask questions and are willing to take treatment decisions collectively will be more popular, more successful and their patients will follow their advice more readily.

Another change in the doctor patient relationship that I observe is that it used to be very formal and it has now become more casual. Studies show that a vast majority of the patients want their doctor to address them by their first name. The small minority of patients who do not like this informality, the majority of them are over the age of 65. This study also revealed that the vast majority of the patients still hesitate to call the doctor by his first name !

This beautiful relationship can give a lot of joy to both patients and doctors if both parties follow some simple rules. And these are:

For the patient: Trust and respect.

For the doctor: Competence, honesty, always-always the patient’s best interest in mind, openness, give time and empathy.