The Doctor-Patient Relationship in US Primary Care

Lings, Pam; Evans, Philip; Seamark, David; Seamark, Clare; Sweeney, Kieran; Dixon, Michael; Gray, Denis Pereira

doi:10.1177/014107680309600406

Cited by 25 publications

(51 citation statements)

References 11 publications

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“…6 In one study, liking was described as "having an easy and comfortable relationship with the doctor." 37 Over time, patients enjoy feeling known 17 and having a sense of familiarity with the physician. 6 For some patients the relationship was characterized as a mutual bond, similar to friendship.…”

Section: Doctor-patient Relationshipmentioning

confidence: 99%

Patients' Perceptions of Interpersonal Continuity of Care

Pandhi¹,

Saultz²

2006

The Journal of the American Board of Family Medicine

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Section: Doctor-patient Relationshipmentioning

confidence: 99%

Patients' Perceptions of Interpersonal Continuity of Care

Pandhi¹,

Saultz²

2006

The Journal of the American Board of Family Medicine

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“…No studies were rejected because of serious concerns about methodological quality (Appendix Table 2). The characteristics of the final 11 studies included in the synthesis [16][17][18][19][20][21][22][23][24][25][26] are summarised in Table 1. The aims, participants and key findings are summarised in Table 2.…”

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confidence: 99%

“…Knowledge emerged as a dominant aspect contributing to depth of relationship. 16,17,[19][20][21][22][23]25,26 Studies described both patients' knowledge of the doctor, and doctors' knowledge and understanding of the patient.Many patients like 'knowing' the doctor. 16,20,23,25 This might start with a simple familiarity with what they look like, but may develop into more personal knowledge, for example, concerning the doctor's personality.…”

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confidence: 99%

“…This final aspect of the depth of patient-doctor relationships is a primarily affective attribute. It comprises comfort 17,21 and liking, 16,17,23 which reflect perceived care from the doctor and respect in the relationship. [20][21][22]24,25 As a consequence of doctors appearing interested and 'on side' with patients, patients feel that they matter to the doctor.…”

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confidence: 99%

See 1 more Smart Citation

The patient–doctor relationship: a synthesis of the qualitative literature on patients' perspectives

Ridd¹,

Shaw²,

Lewis³

et al. 2009

Br J Gen Pract

274

226

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The patient-doctor relationship is an important but poorly defined topic. In order to comprehensively assess its significance for patient care, a clearer understanding of the concept is required. AimTo derive a conceptual framework of the factors that define patient-doctor relationships from the perspective of patients. Design of studySystematic review and thematic synthesis of qualitative studies. MethodMedline, EMBASE, PsychINFO and Web of Science databases were searched. Studies were screened for relevance and appraised for quality. The findings were synthesised using a thematic approach. ResultsFrom 1985 abstracts, 11 studies from four countries were included in the final synthesis. They examined the patient-doctor relationship generally (n = 3), or in terms of loyalty (n = 3), personal care (n = 2), trust (n = 2), and continuity (n = 1). Longitudinal care (seeing the same doctor) and consultation experiences (patients' encounters with the doctor) were found to be the main processes by which patient-doctor relationships are promoted. The resulting depth of patient-doctor relationship comprises four main elements: knowledge, trust, loyalty, and regard. These elements have doctor and patient aspects to them, which may be reciprocally related. ConclusionA framework is proposed that distinguishes between dynamic factors that develop or maintain the relationship, and characteristics that constitute an ongoing depth of relationship. Having identified the different elements involved, future research should examine for associations between longitudinal care, consultation experiences, and depth of patient-doctor relationship, and, in turn, their significance for patient care. INTRODUCTIONThe patient-doctor relationship is an important concept in health care, especially primary care. However, it is also a complex topic that means different things to different people. As a consequence of this, research in the area has been somewhat fragmented.Many studies have investigated it in terms of the communication and interpersonal skills of the doctor. [1][2][3][4] Another major facet is continuity of patient care, where the relational aspect is referred to as interpersonal continuity. [5][6][7] More recently there has been interest in examining the characteristics of the ongoing relationship itself, such as trust. 8 The patient-doctor relationship can be seen as a specialised form of human relationship, and work in other disciplines has distinguished between the dynamic interactive aspects of relationships and the mental associations made by people 'in' relationships, which are 'historically derived representations of experience'. 9 All of these elements are thought to be important, but in the absence of a conceptual framework that can be applied to patient-doctor relationships, we are unlikely to establish the significance of the different parts and how they affect patient care. Broadly speaking, the patient-doctor relationship can be viewed as either a process or an outcome, and opinion on which is most appropriate is divi...

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“…2 It has also been shown that a good continuing relationship with the GP leads to much lower health costs 3 and less use of secondary care. 4 Finally, there are clear indications that strong general practice and primary care reduces social inequalities in health through empowerment of individuals and communities and social cohesion. 5 This importance of relationship continuity with a generalist has been insufficiently valued in recent years, not least by GPs themselves.…”

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confidence: 99%