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Prof.Dr.T.BedirhanÜstün
DoctorPatientRelationship
Objectivesofthislecture
Attheendofthelecturethestudentshouldbeableto
1. Understand keyaspectsofdoctor-patientrelationship
2. Applyself-evaluationonbeingobjective,neutralandnon-judgemental
PatientBillofRights
• Righttoaccesscare• Equaltreatment• Demandinformation• Righttochoosedoctorandinstitution• Confidentiality• Informedconsent• Security• Religiousrespect• Humanvalues• Accesstovisitors
Thedoctor–patientrelationship
• keytothepracticeofhealthcare• essentialforthedeliveryofhealthcare
• Humanrelationship– social&psychological
• Knowledgeexchange:problem-identificationandsolving
• thediagnosisandtreatmentofdisease
• Improvinghealthcultureinthesociety
Perspectives
Medical
Personal Social
Perspectives
Doctor
Patient Society
Perspectives
Disease
Sickness Illness
Describe“a”doctorpatientrelationship
• Whatmakesa“good”doctor?
Whatmakesa“good”doctor?
• Listening• Interest– concern• Respect• Flexibility• Knowledge• Subjectmatter• Generalexamination– interviewtechniques• Symptomaticreadingofthepatient• Relationshipreading
SHOCKINGFINDINGSfromRESEARCH
• 60%oftapedinterviewsshowedinterruptioninfirst20seconds
• In50%ofthecases:doctorsandpatientsdidnotagreeonthekeyproblem
• 80%ifthecasescouldnotadequatelyrepeattheprescription
EMPATHY
• Understandingtheother’scondition• Feelinginother’sshoes• Seeingthesituationthroughtheireyes• Donotjudge– justtrytounderstand• Recognizetheirmotives• Ask– communicate- discover
Emotions
Doctor– Patientencounter
Cognition
• Pleasure• Fear• Anger• Sorrow• Disgust• Surprise
• (Anxiety)• (Trust)
USEYOURSELF:TransactionalAnalysis
Parent
Adult
Child
Parent
Adult
Child
Doctor Patient
ADoctorshould…
•beabletorelatetodiverserangeofpeople• Understandtheirpersonality• Communicate withthem
•understandthepsychological– behavioralandsocial aspectsoftheirlives
Extroversion Introversion
Where do we vest our energy?
Speed Reading
How do we make decisions?
Thinking Feeling
How do we organize our world?
Judging Perceiving
How do we take in information?Sensing Intuition
YourProfileintellsalot…
• https://applymagicsauce.com
YourProfileintellsalot…
Describe“a”doctorpatientrelationship
• Whatmakesa“good”doctor?
• Whatmakesthepatient“satisfied” ?
• Rightdiagnosis– rightintervention– rightbehaviour ?
• Dopatientshavetherighttochoosedoctors?
• Dodoctorshavetherighttochoosepatients?
DOCTORLow Control High Control
PATIENT
LowPart. Default Paternalism
Omnipotence
HighPart. Consumerism Mutualbalance
ChangingRoleofDoctors
• Biopsychosocialapproach
• Facilitator/Listener
• BehaviorChangeExpert
• Patient-CenteredCommunication
Communication
YOU• Think• wishtoexpress• thinkyouhavejustexpressed• youexpressed• …
OTHERONE• wants tohear• Actuallyhears• wishestounderstand• understands• …
RequirementsofagoodDoctor-PatientRelationship
Doctor• Accessible– available• Reliable– trustworthy• Standardofcare• Willingnesstohelp• Goodevaluation– judgement• Communicateeffectively• Objectivity• Neutrality• Non-judgemental• Non-discriminatory
Patient• Takeresponsibilityinownhealth• Provideaccurateinformation• Collaboratewithprovider• Followtreatment
Whatisyourownevaluation:Whateffectsyour …
1. Objectivity?
2. Neutrality?
3. Non-judgmentalstance?
• Gender– sexualpreference• Age• CountryofOrigin• Socialstatus• Typeofillness
• HIVstatus• Smoking• Alcoholintake
• EconomicStatus• ….
Summary:
• Makeyourselfavailable,accessible andinterested inyourpatients• Avoiddistractions
• Listenintensely• Observeintelligently• Makeempathywithyourpatientsandusethisinunderstandingthem• Communicateindailylanguage• Preferopenendedquestions• Trybeingobjective– neutral– non-judgmental
