Do you avoid the doctor? Improving patient-physician relationship

The doctor smiles while talking to the patient at the officeFor many, the family doctor is the person we are addressing with some of our most vulnerable personal information. We go to our doctor to talk about how to keep ourselves healthy and how to manage illnesses. Sometimes we share details that we may not even share with our partner.

We hope that our doctors will provide us with no crisis. Doctors also hope that they can serve their patients well and that they can use their training and knowledge. This can be a great relationship in which patients feel that they are heard, understood and cared for by their doctors. However, given the patient's vulnerability and the pressure faced by doctors, this relationship can be destroyed, often at a high cost for patients.

In my treatment practice, I often speak to people who feel misunderstood or poorly maintained in search of medical health services and develop a kind of phobia around working with doctors. This can happen to any person, but I have noticed that this concern is usually shown by a variety of people. in particular, people who are racist, LGBTQ + people and people with different abilities.

What is a good relationship with a doctor?

The ideal doctor-patient relationship has shifted over time. It has moved from a more authoritarian model, in which patients trust and adhere to doctors, in a patient-centered approach, in which patients are seen as autonomous and holistic individuals. Today, doctors often work to understand the medical problems through the lens of the single patient (Kaba & Sooriakumaran, 2007).

Establishing a strong doctor-patient relationship is trust, knowledge of the other, respect and faith. These factors influence the effects of the physical and mental health of patients (Chipidza, Wallwork, & Stern, 2015). In an ideal doctor-patient relationship:

  • The patient believes that the doctor is competent and cared for.
  • The doctor trusts the patient's experience.
  • The patient and the doctor know each other.
  • The patient feels as if their doctor likes them and supports them.
  • The patient is willing to forgive mistakes that his doctor can do.
  • The doctor does not leave the patient.

Unfortunately, with the reality of time constraints, the high proportion of patients with each physician, the cost associated with health care and the management of the urgency faced by doctors, it may be very difficult to develop the ideal doctor-patient relationship. Many of my clients believe that their doctors do not try enough, they do not understand them or have the "wrong idea" about them. Many of my clients who are doctors believe that systemic healthcare problems affect their ability to provide care according to the standard they want.

What is the impact of a poor doctor-patient relationship?

When patients feel unrepentant, neglected, or have different health plans from their doctor, there may be adverse effects on medical and mental health (Gordon & Beresin, 2017), including decreasing adherence to treatment, emotional changes status and symptoms, a change in visit frequency, and a change in response tools. Since the goal of medical work with a doctor is to improve health, it is clearly imperative that the patient and their doctor have the best possible relationship.

From my observation, the cost of a poor doctor-patient relationship extends beyond the effects of physical health. Customers report a deep disbelief as to the elements of power, shame, self-criticism about their perceived failure to "improve" and avoiding health professionals who go beyond this appointment with a doctor.

Although the root of these problems is often multi-faceted, patients who realize that they have been mistakenly treated, disliked or infected by their doctors, or whose trust and confidentiality have been violated, are traumatized by these conditions that affect their general health and psychological prosperity

For some patients, this means that mental health problems are not cured for a long time, influenced by the fear that a doctor will judge mental health symptoms hard. Some patients even experience a phobia of doctors, called iotropy. Although the root of these problems is often multi-faceted, patients who realize that they have been mistaken, disliked or infected by their doctors, or whose trust and confidentiality have been violated, cause injury to those situations that affect general health and health their psychological well-being.

How to edit negative experiences with doctors

The first step to understanding how your relationship with your doctor affects is to examine how you feel about visiting your doctor. Consider what you liked or disliked about the experience and determine if you have the basis of trust, will, faith and knowledge in your relationship with your doctor.

You may want to talk to your feelings with a trusted friend, family member or therapist who understands your situation. If you feel that you can trust your doctor and that you may be able to directly express your feelings about your care to your doctor, then this may be a great first step in repairing damage that was probably unintentional.

Recognize that for many patients, especially for those who are LGBTQ + or who come from different backgrounds from their doctor, the lack of information from the doctor may harm the patient-doctor relationship. Recognizing that the problem may not be for you and instead of the lack of information or knowledge from the doctor can help you depersonalize the situation and consider other options.

What do you need from your doctor?

Consider collecting information about your specific problem, how it usually manages and what you want to see with your health before visiting your doctor. It may be that what bothers you is related to the inconvenience of the treatment options and there may be alternatives. It may also be that you feel that you have a greater problem with your doctor, which can be examined through the registration agency. You may be able to find other doctors who feel more comfortable or think you understand your situation more carefully.

If you experience a medical phobia and medical procedures, it may be helpful to look for a therapist who can work with you for it. The most common approach to treating phobias is exposure therapy that is designed to help you gain comfort and create tools to manage the fear and anxiety that arise when you go to an appointment or have to participate in medical procedures ( Milosevic & McCabe, 2015). You can also participate in cognitive behavioral therapy (CBT), hypnotherapy or group counseling.

Ensuring that you seek timely and adequate medical care can make a big difference to your overall health and deserves to work on this.

Bibliographical references:

  1. Chipidza, F.E., Wallwork, R.S., & Stern, T. A. (2015). Effect of Doctor-Patient Relationship. Primary Care Partner for CNS Disorders, 17(5). two: 10.4088 / PCC.15f01840.
  2. Gordon C. & Beresin, E. V (2016). The Doctor-Patient Relationship. In Massachusetts General Hospital Clinic Psychiatry. Philadelphia, PA: Elsevier Health Sciences.
  3. Kaba, R., & Sooriakumaran, P. (2007). The evolution of the doctor-patient relationship. International Journal of Surgery, 1(5), 57-65. doi: 10.1016 / j.ijsu.2006.01.005
  4. Milosevic, I. & McCabe, R. E. (Eds.) (2015). Phobia: The psychology of absurd fear. Santa Barbara, California: Greenwood.
  5. Ridd, M., Shaw, A., Lewis, G., & Salisbury, C. (2009). The Patient-Doctor Relationship: A synthesis of quality literature on patient outlook. The British Journal of General Practice, 59(561), 116-133. two: 10.3399 / bjgp09X420248

© Copyright 2018 All rights reserved. The publishing permission was granted by Laura Turnbull, MC, CPsych, a therapist in York, Ontario

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