Doctor patient relationship

DOCTOR PATIENT RELATIONSHIP

1. Doctor Patient relationship In today’s scenario

2. Association between patient and doctor to treat former’s illness together and reduce his/her sufferings Patient – one who is ill and suffering Doctor – one who has skill to treat Definition

3. DOCTOR LOW ROLE DOCTOR HIGH ROLE PATIENT LOW ROLE DEFAULT (AT CONFLICT, DYSFUNCTION, STANDSTILL) PATERNALISM OLD METHOD DOMINANT DOCTOR TREATED AS GOD AND FOLLOWED PATIENT HIGH ROLE CONSUMERISM CORPORATE HOSPITAL PATIENT TREATED AS GOD AND OBLIGED MUTUALITY EQUAL PARTNERSHIP IN DECISION MAKING EXCELLENT COMMUNICATION Types of relationship

4. Good communication – good outcome Bad communication – errors, financial loss, litigation Need – Doctor patient interview Consent Problematic areas – breaking bad news, disclosing death, handling aggressive patient/ families, emergency/ disaster, disclosing adverse events Communication

5. Greetings, establish the rappot Listen patiently Favorable body language – dressing up, sitting posture, eye contact, hand movements Show empathy – be in patient position Avoid unnecessary medical jargon Don’t be judgemental Be clear in your talk Be brief and specific Medical interview

6. Have a positive attitude with a smile Be calm but assertive Adapt to audience Understand body language and non verbal clues Be open minded BREAKING BAD NEWS – by treating consultant, separate room, give time, should have knowledge of case, in patient language, no jargons, use experience, plan out before with team

7. Answer queries Give respect Establish and respect boundaries Be ethical – avoid unnecessary diagnosis and treatment Barriers Doctor – lack of knowledge, counselling skills, time, resources, interest Patient – sex, social and educational level, language

8. A DOCTOR CAN DO A LOT MORE WITH HIS WORDS THAN HIS MEDICINE HAVE A RELATIONSHIP OF FISH AND WATER NOT OF FISH AND FISHERMAN

9. Respect for personal dignity and privacy during examination Confidentialty – avoid discussion in public places, patient information not to be revealed HIV status – cant be written on front of file, OPD slip, cant be revealed Right for information about care plan, progress Inform about alternatives, expected outcomes, possible complications Inform about results of diagnostic tests Inform about change in patient condition Patient rights

10. Right to refuse treatment – counsel and document and take acknowledgement Right to second opinion – within or outside, give assess to all records Written Informed consent – surgery, anaesthesia , procedure, blood transfusion, admission Right to know about expected cost of treatment Right to know the names of health care professionals – I cards and dress code

11. Proper history and credentials To be on time To take medications regularly, follow advise Respect towards doctor No alcohol, smoking, weapons No violence To share insurance data Follow up regularly Pay bills Give priority to emergencies Patient responsibilities