Ustun 2017 doctor patient relationship
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Koç University Medical School; Year 2 lecture on Doctor-Patient Relationship; KUSOM
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Ustun 2017 doctor patient relationship
- 3. Objectives of this lecture At the end of the lecture the student should be able to 1. Understand key aspects of doctor-patient relationship 2. Apply self-evaluation on being objective, neutral and non-judgemental
- 4. Patient Bill of Rights • Right to access care • Equal treatment • Demand information • Right to choose doctor and institution • Confidentiality • Informed consent • Security • Religious respect • Human values • Access to visitors
- 6. The doctor–patient relationship • key to the practice of healthcare • essential for the delivery of health care • Human relationship – social & psychological • Knowledge exchange: problem-identification and solving • the diagnosis and treatment of disease • Improving health culture in the society
- 12. What makes a “good” doctor ? • Listening • Interest – concern • Respect • Flexibility • Knowledge • Subject matter • General examination – interview techniques • Symptomatic reading of the patient • Relationship reading
- 13. SHOCKING FINDINGS from RESEARCH • 60% of taped interviews showed interruption in first 20 seconds • In 50 % of the cases: doctors and patients did not agree on the key problem • 80% if the cases could not adequately repeat the prescription
- 14. EMPATHY • Understanding the other’s condition • Feeling in other’s shoes • Seeing the situation through their eyes • Do not judge – just try to understand • Recognize their motives • Ask – communicate - discover
- 15. Emotions Doctor – Patient encounter Cognition • Pleasure • Fear • Anger • Sorrow • Disgust • Surprise • (Anxiety) • (Trust)
- 17. A Doctor should … • be able to relate to diverse range of people • Understand their personality • Communicate with them • understand the psychological – behavioral and social aspects of their lives
- 18. 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
- 21. Describe “a” doctor patient relationship • What makes a “good” doctor ? • What makes the patient “satisfied” ? • Right diagnosis – right intervention – right behaviour ? • Do patients have the right to choose doctors? • Do doctors have the right to choose patients?
- 22. DOCTOR Low Control High Control PATIENT Low Part. Default Paternalism Omnipotence High Part. Consumerism Mutual balance
- 23. Changing Role of Doctors • Biopsychosocial approach • Facilitator/ Listener • Behavior Change Expert • Patient-Centered Communication
- 24. Communication YOU • Think • wish to express • think you have just expressed • you expressed • … OTHER ONE • wants to hear • Actually hears • wishes to understand • understands • …
- 25. Requirements of a good Doctor-Patient Relationship Doctor • Accessible – available • Reliable – trustworthy • Standard of care • Willingness to help • Good evaluation – judgement • Communicate effectively • Objectivity • Neutrality • Non-judgemental • Non-discriminatory Patient • Take responsibility in own health • Provide accurate information • Collaborate with provider • Follow treatment
- 26. What is your own evaluation: What effects your … 1. Objectivity ? 2. Neutrality ? 3. Non-judgmental stance ? • Gender – sexual preference • Age • Country of Origin • Social status • Type of illness • HIV status • Smoking • Alcohol intake • Economic Status • ….
- 27. Summary: • Make yourself available, accessible and interested in your patients • Avoid distractions • Listen intensely • Observe intelligently • Make empathy with your patients and use this in understanding them • Communicate in daily language • Prefer open ended questions • Try being objective – neutral – non-judgmental