- Dr. Gaurav Sharma
- Aug 17 2017
One of the most important components of the physician-patient relationship and of physicians' relationships with the various communities they serve is 'trust' where unlike other professions a one-to-one family level bond is established that allows the physician to assess his patient from physical, psychological, and environmental perspectives and helps to build a "Therapeutic Alliance" between the physician and the patient.
The patient-physician relationship ought to be regarded as more egalitarian than paternalistic, as based on earned trust ("Trust me, because I have shown that you can trust me") rather than on blind trust ("Trust me, because I know what is best for you").
A very important aspect of a family physician is the 'personal bonding' with the patient. The patient should eventually feel being 'heard' completely and compassionately at the end of the interactive session with his physician. This to my knowledge and belief is one of the most critical aspect of clinical practice, but paradoxically it remains one of the most neglected and ignored element of holistic clinical practice. Most of the undiagnosed or under-treated cases returning even from multispecialty hospitals that I have encountered were those 'unheard' patients ignored in the hustle bustle of hi-fi dramatic five minute consulting or cross referrals of the patient from one specialist to another, one lab to another, and eventually labeling the diagnosis as 'Idiopathic' or in many cases as 'Psychosis'.
Although, I completely agree that medical knowledge is ever evolving on a daily basis and at the same time many diseases too are ever evolving to evade the medical knowledge, I strongly believe that 'diagnosis' will always remain the most crucial skill of a physician, and the rest of medical management will automatically fall in place. And for the right diagnosis, the most important skill that an able physician owes is empathic listening and astute observation.
A common excuse that I hear very often from fellow physicians is 'lack of time' owing to the high number of patients or their otherwise busy schedules. However, I strongly believe that an "optimum patient-physician interaction time" is not only valuable to the patient but also to make a righteous clinical judgement based on patient's detailed narrations that often carry the most valuable clues of diagnosis and that coupled with a thorough clinical examination further ascertains the diagnosis while minimizing the need of complicated and expensive diagnostic lab tests.