Doctor-Patient

Relationship
Dr. Truong Trong Hoang, M.D.
Master of Arts in Health Social Sciences
 Learning objectives
After completing the lesson, the learners will be
able to:
• Present the nature of the doctor-patient
relationship
• Have basic skills in doctor-patient
relationship.

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 https://www2.primepractice.com.au/the-power-of-good-dental-
patient-communication

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https://enfoquedental.com/en/new-dentist-patient-relationship/

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 • According to Howard B Beckman, problematic
relationship issues were identified in 71% of the
depositions between 1985 and 1987 in US:
• deserting the patient (32%)
• devaluing patient and/or family views (29%)
• delivering information poorly (26%)
• failing to understand the patient and or family
perspective (13%).

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 • Have you ever gone to a dental clinic?
• If you have ever gone there, how did you feel
about the health care professionals there?
(Please list not more than 3 feelings)

bit.ly/3f1R121

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 • Health care
• Careful 
• Careless 

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 The Doctor-Patient Relationship
• At the core of the practice of medicine
• The patient expects a good relationship as much as
a cure
• Doctor-patient relationship itself becomes part of
the therapeutic process.

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 What do patients want from a
physician?
According to Delbanco, 1992 (cited by Eustice)
• Patients want to be able to trust the competence
and efficacy of their caregivers.
• Patients want to be able to negotiate the health
care system effectively and to be treated with
dignity and respect.
• Patients want to understand how their sickness or
treatment will affect their lives, and they often fear
that their doctors are not telling them everything
they want to know.

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 “Good physician treats the disease; the great
physician treats the patient who has the disease.”
William Osler (Canadian Physician, 1849-1919)

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 https://suckhoe.vnexpress.net/tin-tuc/suc-khoe/bo-y-te-yeu-cau-ky-luat-bac-si-gac-chan-len-ghe-
doi-thoai-nguoi-nha-benh-nhan-3640445.html

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 Medical Professionalism
Medical professionalism embodies the values
and skills that the profession and society
expects of doctors.
(Australian Medical Association)

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 Medical Professionalism
• Today’s definition of medical professionalism is
evolving –
• from autonomy to accountability,
• from expert opinion to evidence-based medicine,
• from self-interest to teamwork and shared
responsibility. 

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 Medical Professionalism
“More than the adherence to a set of medical
ethics, it is the daily expression of what originally
attracted them to the field of medicine – a desire to
help people and help society as a whole by
providing quality health care to those in need.”

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 Importance of effective
doctor-patient communication
1. Accurate diagnosis
2. Enhancing patient adherence to treatment plans
3. Contributing to doctor clinical competence and
self assurance
4. Contributing to patient satisfaction

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 Importance of effective
doctor-patient communication
5. Contributing to cost and resource effectiveness
by preventing unnecessary prescriptions for
medication that are either wrongly prescribed or
not properly used by patients.

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 Factors which influence
Doctor-Patient Communication
• The setting
• Patient-related factors
• Doctor-related factors.

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 The setting
• Privacy
• Comfortable surroundings
• An appropriate seating arrangement
• etc.

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 Patient-related factors
• Physical symptoms
• Psychological factors
• Previous experience
• Current experience.

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 Doctor-related factors
• Physical factors
• Psychological factors
• Personality
• Training in communication skills
• Self-confidence in ability to communicate.

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 Patients who feel at ease
• and who are encouraged to
talk freely
• are more likely to disclose the
real reason for consulting.

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 Communication skills
A) Core communication skills:
• Doctor-patient interpersonal skills
• Information gathering skills
• Information giving skills.

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 Communication skills
B) Advanced communication skills:
• Skills for motivating patient adherence to treatment
plans
• Skills for specific situations.

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 Core Communication Skills
1- Doctor-patient interpersonal skills:
• Creating an appropriate physical environment
• Empathy
• Showing respect and interest
• Showing warmth and support

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 Core Communication Skills
1- Doctor-patient interpersonal skills:
• Using appropriate language
• Developing a collaborative relationship.

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 Core Communication Skills
2- Information gathering skills:
• Clarifying the information given to the patient
• Active listening:To show that the therapist is
attending closely the patient
• Sequencing of events
• Directing the flow of information
• Summarizing.

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 Core Communication Skills
3. Information giving skills:
• Providing clear and
simple information
• Using analogy

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Core Communication Skills

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2021
 Core Communication Skills
3. Information giving skills:
• Using specific advice with concrete examples
• Pushing important things first
• Using repetition (restatement)

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 Core Communication Skills
3. Information giving skills:
• Summarizing
• Categorizing information to reduce complexity and
aid recall
• Using tools such as diagrams, written instruction
and technical aids to explain the information being
given

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 Core Communication Skills
3. Information giving skills:
• Checking patient understanding of what has been
said
• Asking patients to repeat back what they had heard
and understood.

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 Core Communication Skills
4. Motivating patient adherence to treatment plans:
• Giving time for patients to ask questions

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 Core Communication Skills
4. Motivating patient adherence to treatment plans:
• Giving feedback using And structure rather than But
structure.
“You are good at these points A, B, C, and you will get
good results if you do these points X, Y, Z.”
Rather than “You are good at these points A, B, C, but you
are bad at these points D, E, F.”

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 Core Communication Skills
4. Motivating patient adherence to treatment plans:
• Confronting the patients with bad results but with a
neutral tone (gentle confrontation)
“If someone did not do these things A, B, C, he/she will get
X, Y, Z.”
• Trusting in patients and encouraging them to
adhere to treatment plans
“I believe that you can do these A, B, C things [and you will
get good results].”

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 “Communication skills can be
developed with practice, patience
and a willingness to learn”
Sonia Sehgal
 Y đức trong giáo dục sức khỏe

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 Practical exercise
A patient, when she goes back to your dental
clinic, gets angry and forces you to pay
compensation as the dental treatment is expensive
but after only one week the fillings has fallen
down. Write down the dialogue between you and
your patients to solve the problem.

bit.ly/3xTR221

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 References
• Albert R. Jonsen et al. Professionalism.
https://depts.washington.edu/bioethx/topics/profes.html
• Carol Eustice. The Doctor-Patient Relationship-Impacting
the Success of Treatment. Updated February 06, 2018.
https://www.verywellhealth.com/the-doctor-patient-relatio
nship-188050
• Holly J. Humphrey. Doctor-Patient Relationship and
Medical Professionalism. The University of Chicago Pritzker
School of Medicine (ppt)
• Sonia Sehgal. The Patient-Doctor Relationship. (ppt)

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 References
• The Doctor-Patient Relationship-From Sociology as applied
to Medicine. (ppt)
https://fac.ksu.edu.sa/sites/default/files/physician_patient_
relationships.ppt

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 • Link for ppt files:

bit.ly/3b9R321

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Have happy time
doing your study