Physician-Patient Relationship: The Present Situation and Our Responsibilities

Islam,; Jhora, ST

doi:10.3329/bmj.v41i1.18786

Cited by 8 publications

(8 citation statements)

References 2 publications

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“…Trust in the health system is seen as an important requisite for gaining the confidence of women to participate in shared decision-making [ 41 ]. Islam and Jhora (2012) [ 42 ] identify lack of trust to be a widespread limitation in Bangladesh, in particular when it comes to caring for the poor. In their review of the physician–patient relationship in Bangladesh, they emphasize the physician–patient relationship as being the foundation of contemporary medical ethics and underscore its criticality in providing quality health care services.…”

Section: Discussionmentioning

confidence: 99%

Physician–patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: a mixed-method study

et al. 2021

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Background Caesarean sections (CS) in Bangladesh have risen eight-fold in the last 15 years. Few studies have explored why. Anecdotally, physicians suggest maternal request for CS is a reason. Women and families suggest physicians influence their decision-making. The aim of this research was to understand more about the decision-making process surrounding CS by exploring physician–patient communication leading to informed-consent for the operation. Methods We conducted a mixed-method study using structured observations with the Option Grid Collaborative’s OPTION5 tool and interviews with physicians and women between July and December 2018. Study participants were recruited from eight district public-sector hospitals. Eligibility criteria for facilities was ≥ 80 births every month; and for physicians, was that they had performed CSs. Women aged ≥ 18 years, providing consent, and delivering at a facility were included in the observation component; primigravid women delivering by CS were selected for the in-depth interviews. Quantitative data from observations were analysed using descriptive statistics. Following transcription and translation, a preliminary coding framework was devised for the qualitative data analysis. We combined both inductive and deductive approaches in our thematic analysis. Results In total, 306 labour situations were observed, and interviews were conducted with 16 physicians and 32 women who delivered by CS (16 emergency CS; 16 elective CS). In 92.5% of observations of physician–patient communication in the context of labour situations, the OPTION5 mean scores were low (5–25 out of 100) for presenting options, patient partnership, describing pros/cons, eliciting patient preferences and integrating patient preferences. Interviews found that non-clinical factors prime both physicians and patients in favour of CS prior to the clinical encounter in which the decision to perform a CS is documented. These interactions were both minimal in content and limited in purpose, with consent being an artefact of a process involving little communication. Conclusions Insufficient communication between physicians and patients is one of many factors driving increasing rates of caesarean section in Bangladesh. While this single clinical encounter provides an opportunity for practice improvement, interventions are unlikley to impact rates of CS without simultaneoulsy addressing physician, patient and health system contextual factors too.

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Section: Discussionmentioning

confidence: 99%

Physician–patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: a mixed-method study

et al. 2021

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“…Trust in the health system is seen as an important requisite for gaining the con dence of women to participate in shared decision-making [41]. Islam and Jhora (2012) [42] identify lack of trust to be a widespread limitation in Bangladesh, in particular when it comes to caring for the poor. In their review of the physician-patient relationship in Bangladesh, they emphasize the physician-patient relationship as being the foundation of contemporary medical ethics and underscore its criticality in providing quality health care services.…”

Section: Discussionmentioning

confidence: 99%

Physician-patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: A mixed-method study

Doraiswamy

Billah

Karim

et al. 2020

Preprint

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Background: Caesarean sections (CS) in Bangladesh have risen eight-fold in the last 15 years. Few studies have explored why. Anecdotally, physicians suggest maternal request for CS is a reason. Women and families suggest physicians influence their decision-making. The aim of this research was to understand more about the decision-making process surrounding CS by exploring physician-patient communication leading to informed-consent for the operation. Methods: We conducted a mixed-method study using structured observations with the Option Grid Collaborative’s OPTION5 tool and interviews with physicians and women between July and December 2018. Study participants were recruited from eight district public-sector hospitals. Eligibility criteria for facilities was ≥80 births every month; and for physicians, was that they had performed CSs. Women aged ≥18 years, providing consent, and delivering at a facility were included in the observation component; primigravid women delivering by CS were selected for the in-depth interviews. Quantitative data from observations were analysed using descriptive statistics. Following transcription and translation, a preliminary coding framework was devised for the qualitative data analysis. We combined both inductive and deductive approaches in our thematic analysis. Results: In total, 306 labour situations were observed, and interviews were conducted with 16 physicians and 32 women who delivered by CS (16 emergency CS; 16 elective CS). In 92.5% of observations of physician-patient communication in the context of labour situations, the OPTION5 mean scores were low (5-25 out of 100) for presenting options, patient partnership, describing pros/cons, eliciting patient preferences and integrating patient preferences. Interviews found that non-clinical factors prime both physicians and patients in favour of CS prior to the clinical encounter in which the decision to perform a CS is documented. These interactions were both minimal in content and limited in purpose, with consent being an artefact of a process involving little communication.Conclusions: Insufficient communication between physicians and patients is one of many factors driving increasing rates of caesarean section in Bangladesh. While this single clinical encounter provides an opportunity for practice improvement, interventions are unlikley to impact rates of CS without simultaneoulsy addressing physician, patient and health system contextual factors too.

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“…Hippocrates made an invaluable remark saying “ where there is love for human being, there is love for the art of healing ”. 16 It was reported that Avicenna used to tell his patient: Look!. You, I and disease are “3”.…”

Section: Communicationmentioning

confidence: 99%

Doctor-patient relationship

Chamsi‐Pasha

Albar

2016

SMJ

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The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor’s instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients.

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Physician-Patient Relationship: The Present Situation and Our Responsibilities

Cited by 8 publications

References 2 publications

Physician–patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: a mixed-method study

Physician–patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: a mixed-method study

Physician-patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: A mixed-method study

Doctor-patient relationship

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