Ustun 2017 doctor patient relationship

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

Questions&[email protected]

@ustunb

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