Doctor–patient relationship facts for kids

The doctor–patient relationship is a super important part of health care and how doctors practice medicine. It starts when a doctor helps a patient with their health needs, usually with the patient's agreement. This relationship is built on trust, respect, good communication, and understanding each other. Doctors trust patients to share important information about their health. Patients trust doctors to keep their information private and not share it with others.

Doctors also promise to follow special rules and guidelines, like the Hippocratic Oath. A good doctor–patient relationship helps patients get the best care and helps doctors do their best work. Nowadays, healthcare focuses more on the patient, which has changed this old relationship.

Why it's Important

A medical practitioner explains an x-ray to the patient.

The doctor is providing medical advice to this patient.

A physician performs a standard physical examination on his patient.

Patients need to trust that their doctor is skilled and that they can share anything with them. For most doctors, building a good connection, called rapport, with a patient is key. Some medical areas, like psychiatry (mental health) or family medicine, focus more on this relationship than others, like pathology (studying diseases) or radiology (X-rays), where doctors don't talk to patients as much.

A strong relationship helps both the doctor and the patient. When doctors and patients understand each other's views on health and life, it builds a better connection. A good relationship means patients share more information, leading to better care and more accurate diagnosis. If the relationship isn't good, the doctor might not get all the information needed, and the patient might not trust the diagnosis or treatment plan. This can lead to patients not following medical advice, which can make their health worse. In such cases, a patient might get a second opinion or find another doctor they trust.

Researchers like Michael Balint and Enid Balint in the UK studied the doctor–patient relationship. Their work showed how important this connection is.

How the Relationship Works

Asking for Permission

Doctors show respect by telling patients the truth about their health. They also ask for the patient's informed consent before giving any treatment. This means the patient agrees to the treatment after understanding it. In the past, people often thought "the doctor always knows best." But now, patients have the right to choose their care and agree to medical procedures.

Sometimes it's tricky. What if a patient doesn't want to know the full truth about their condition? Or what about using a placebo (a fake treatment)? Does giving a sugar pill break trust? These are tough questions that doctors think about using medical ethics.

Making Decisions Together

Shared decision making means both the doctor and the patient work together to decide on treatment. This usually involves both sides sharing information and agreeing on a plan.

The doctor doesn't just tell the patient what to do. Instead, the patient's choices are respected, and they pick the medical treatment they want. It's considered wrong for a doctor to make health decisions without thinking about the patient's goals or getting their ideas.

Doctors can talk about risks in different ways. Some doctors use a "negotiated approach." This means they have an open chat with the patient and find a plan that both agree on. This helps doctors and patients work together. Other doctors might use a "technocratic approach," where the doctor makes all the decisions and expects the patient to just accept them. This way, the doctor acts like they know everything, and the patient has little say.

Doctor's Communication Style

How a doctor talks is super important for the relationship. When doctors use "patient-centered communication," they ask open-ended questions, are friendly, encourage patients to share their feelings, and show interest in the patient's life. This makes the relationship better. It can also help patients feel more positive about doctors and healthcare, and even follow treatment plans more closely.

When doctors share a little about themselves, it can also help. Even though doctors were once told not to share personal feelings, it can build trust and make patients feel more comfortable sharing their own information. This is linked to empathy, which is about understanding and sharing the feelings of another. How a doctor responds to a patient's emotions also matters. If a doctor listens and lets patients talk about their feelings, patients feel more comfortable discussing sensitive topics important for their care. If a doctor avoids or dismisses feelings, patients might not open up.

Doctor's Power

Historically, doctors were often seen as more powerful or superior to patients. This is because doctors control health, treatment, and have special knowledge. In the past, doctors might only share enough information to convince the patient to follow their plan. Patients often feel helpless because they are suffering and need the doctor's help. A good doctor knows this and tries to create a comfortable, trusting environment to talk openly. It's also good for doctors and patients to work together, with patients taking more responsibility for their own care.

Patients usually don't understand the medical science behind their condition. That's why they go to a doctor! Not understanding what's happening to their body can be scary and frustrating.

When doctors explain the diagnosis, test results, and treatment options in simple words that patients can understand, it can be very reassuring. It helps patients feel more in control. This strong communication also makes the doctor–patient relationship better and helps patients follow their treatment plans, leading to better health.

Doctor's Biases

Doctors sometimes think they are better at communicating than they actually are. They might also underestimate how much information patients want, especially if patients haven't gone to college or come from poorer backgrounds. Studies show that patients who are better educated or from wealthier families often get more and better information from doctors, even though everyone wants to know about their health.

A patient's race, background, and language can also affect how doctors see and talk to them. Some studies have shown that doctors might have different ideas about patients from different backgrounds. For example, some studies found that African American patients received less pain medication than Caucasian patients, even when their pain levels were similar. Other studies showed that doctors built less rapport and showed less empathy with Black and Hispanic patients, even without language barriers.

Not Trusting Doctors

Mistrust of doctors or the healthcare system is called medical mistrust. This can hurt the doctor–patient relationship. If a patient doesn't trust their doctor, they are less likely to listen to advice, follow treatment plans, or share important information. When doctors communicate well, like sharing a bit about themselves or using patient-centered communication, it can help reduce this mistrust.

Medical mistrust is often higher among minority groups. This can lead to patients not following medical advice and having worse health outcomes. For example, some studies found that African American women with medical mistrust were less likely to talk to their doctor about concerning mammogram results or wait longer to report symptoms of ovarian cancer.

Helping the Patient

Sometimes, doctors and patients might disagree on the best treatment. In these cases, the doctor needs to explain difficult treatment options or unwelcome news in a way that helps the patient's health without hurting the relationship. If a patient can't or won't follow the doctor's advice, it's called being "non-adherent." Doctors might use Adherence management coaching to encourage patients to make good choices.

For example, a study in Scotland found that most patients liked or didn't mind being called by their first name. But most patients didn't want to call the doctor by their first name.

Changing Doctors

When patients move between different healthcare providers, it can sometimes lower the quality of care until a new doctor–patient relationship is built. Having the same doctor or team over time, called continuity of care, usually helps the relationship. Sometimes, different doctors or teams need to work together, which is called integrated care.

Talking and Listening

Researchers study how doctors and patients talk to each other. One important idea is turn-taking, which is how people take turns speaking in a conversation. This greatly affects the relationship. Often, a doctor will ask many questions about a patient's history, examination, and diagnosis. This first talk often sets the tone for the whole relationship.

Studies have shown that doctors interrupt patients more often than patients interrupt doctors. This can make it seem like doctors think they are more important or know more. While too many interruptions from a patient can make treatment less effective, doctors should be careful not to interrupt too much. This is something easy to fix! Studies also show that men are more likely to interrupt than women. This means male doctors might need to encourage female patients to share more, and female doctors might need to make sure male patients let them finish speaking.

Patients often tell their story in order, mixing symptoms, test results, and treatments. Doctors, however, tend to look for details step-by-step. If doctors and patients understand these different ways of thinking at the start of a visit, it can help avoid interruptions and make the relationship better.

Other People Involved

Sometimes, other people are in the room during a doctor's visit, like parents with a child. They can offer support, but sometimes they might make it harder for the patient to share private or uncomfortable things. This can affect doctor–patient confidentiality.

Having family around during difficult medical situations can also cause problems. Family members might disagree with the patient or doctor about treatment, which can create stress for everyone.

Online Doctor Visits

With lots of technology in healthcare, a new way of seeing doctors has appeared: Telehealth. This means using phones, computers, or other electronic tools to help patients. Telehealth can make healthcare easier to get, more affordable, and more convenient for both doctors and patients. Some challenges include getting paid for these visits, rules for doctors working across different states, and keeping information private.

Telehealth can be used for many types of care, like general check-ups, getting prescriptions, skin problems, eye exams, nutrition advice, and mental health counseling. Just like an in-person visit, it's good to prepare for a telehealth appointment and communicate well with your doctor.

An interesting change with telehealth is that doctors are taking on a new role. Patients now have more access to health information and their own health data. So, doctors are becoming like "translators" who help patients understand complex medical information. They also act as guides and managers for collecting and sharing patient data. This is a new and changing part of the doctor–patient relationship.

Bedside Manner

A medical doctor, with a nurse by his side, performs a blood test at a hospital in 1980.

Bedside manner is how a doctor acts and talks to a patient.

• A good bedside manner makes the patient feel calm and safe, while still being honest about their health.
• Things like a doctor's voice, body language, how open they are, and whether they seem present can all affect their bedside manner.
• Poor bedside manner leaves patients feeling unhappy, worried, scared, or alone.
• It's hard for doctors to have good bedside manner when they have to give bad news without scaring the patient.

Dr. Rita Charon started the idea of "narrative medicine." She believed that if doctors understood a patient's personal story better, they could provide better medical care.

A study found five main things patients want from their doctors: 1. Patients want their doctors to reassure them. 2. Patients feel nervous asking questions and want doctors to tell them it's okay to ask. 3. Patients want to see their lab results and have the doctor explain what they mean. 4. Patients don't want to feel judged by their doctors. 5. Patients want to be part of making decisions about their medical care.

For example, patients in the emergency department feel like the doctor spent more time with them if the doctor sat down during the visit, even if the actual time was the same!

Patient Behavior

Being rude can actually affect how well medical care works. A study showed that when hospital staff experienced rudeness from patients or their families, they had trouble doing even simple tasks. This is important because if staff can't do simple things well, it could affect their ability to work in serious situations.

Doctors and Patients in Movies and TV

• Dr. Gregory House from the show House is known for being rude and insensitive, but he's also a brilliant doctor.
• In Grey's Anatomy, Dr. Burke praises Dr. George O'Malley for his "good bedside manner."
• Doc Martin from the British TV series Doc Martin is a good example of a doctor with a bad bedside manner.
• Dr Lily Chao from Casualty has poor bedside manner, while her colleague, Dr Ethan Hardy, has a better one.
• In Lost, Hurley tells Jack Shephard that his bedside manner "sucks."
• In Closer, Larry, the doctor, jokes that he's famous for his bedside manner.
• In Scrubs, J.D has great bedside manner, while Elliot Reid starts with bad bedside manner but gets better. Dr. Cox is tough but still inspires patients.
• In Star Trek: Voyager, the Doctor often brags about his charming bedside manner.
• In M*A*S*H, doctors like Hawkeye Pierce and B.J. Hunnicutt have caring and funny bedside manners to help patients deal with injuries. Charles Winchester learns compassion, while Frank Burns has a poor bedside manner.

See also

In Spanish: Relación médico-paciente para niños