Emotional Relationships Between Doctor & Patients
Healthcare is an issue around the world from the cost of prescription drugs to the care of patients. Issues regarding healthcare is not new, however, the relationship between doctor and patient has become more recognized through time. Communication between doctor and patient is challenging with the use of different languages or the descriptions of unknown illness, however, what I have experienced is the emotional connection between doctors and patients. Studies show the increased developmental connection between doctors and patients, has assisted with faster patient recovery and a more humanized doctor. Through dialogic communication ethics, the understanding between doctor and patient relationships is the desire to learn from each other through individual differences. The purpose of this case study is to show that a more caring relationship will not only bring comfort in a diagnosis setting but a comfort to the recovery of a patient as well.
Emotional Relationships Between Doctor & Patients Through Dialogic Ethics
Like many others, I have visited a doctor as an individual and as a mother. Being exposed as an individual adult to a doctor, I could ask questions concerning my health with little to no emotions. However, when I became a mother, I was also able to ask questions regarding the health of my child, that were full of emotions. Caring for a young life and fielding what I believed would be the best treatment is difficult, even worse for one that cannot speak. I found myself asking several questions that started with what if, not realizing that I set aside my emotions to create a relationship to the doctor. I engaged the doctors as much as I could, always asking the why question, only to get rigid limited answers. The frustration of not getting the answers I deemed essential to construct a decision, only fueled my desire to learn more about the health issues plaguing my son and the medication that was prescribed non-stop. Several doctors, hospital visits, and prescriptions later, I finally realized I needed a compassionate doctor that could not only relate to the medical situation, but to my family as well.
Finding that one doctor proved difficult in a field where everyone knew each other, however, I had kept a notebook of everything, dates, medications, and requested the medical records for my son. I did my research and found a doctor, who took the time to explain the health issues, the medications, and what results we were looking for other than a full recovery. She spent time going over my notebook along with his medical file, answering my questions and answering the why. I was given the bad along with the good, letting me know what to expect when home and knowing that I could contact her services at any time. I needed the relationship that my situation, though not unique, was important. Not just for the care of my son, but for how I was able to control and understand the outcome.
Given the time and care from an individual doctor taught me that the relationship between two people is important for both to recognize that there is more to recovery than just diagnosis and treatment. It is showing compassion, a form of personalized care, and learning from the other to make a more humanized relationship of a difficult situation.
Heath communication is a two-way process, between healthcare providers and individuals. Information is gathered from the patients for the doctors so they in turn can create a prognosis back to the patient. However, healthcare providers create a division by communicating technical information, where the patient then has the burden to respond regarding the type of technical care is needed. The responsiveness between doctors and patients is important toward a patient’s recovery, not only the technical communication. Doctor patient communication is critical and ongoing as it prepares one for future decisions (Arnett, Harden-Fritz, and Bell 2008 p. 195). Communication in health care has evolved regarding the language between a doctor patient relationship and with that change comes the care that is needed for an individual to successfully recover. Today’s society has established that care is an important element and is an area that needs more work.
Doctors have been criticized for their lack of emotions when dealing with patients, bringing one to often wonder, “what if it was them?” Doctors have appeared aloof and uncaring, yet from their perspective of learning as trained in schooling, to survive in the medical field a sense of detachment is needed. Dr. Henry Marsh, a renowned brain surgeon, has learned over the years to say as little as possible when delivering bad news, (Marsh, 2016, p. 152), thus according to Buber (1955) creates an I-It relationship. (Littlejohn and Foss, 2011 p. 254) by not treating others as worthy individuals (p. 254). Dr. Marsh became hardened in his early years and came to see patients as an entirely separate race, however, at the end of his career the detachment of such started to fade (Marsh, 2016, p. 83).
When having to discuss difficult information with patients, doctors can be in the I-It relationship without knowing how the patient truly feels about treatment. Positive effective responsiveness between doctors and patients is viewed as having positive outcomes, not only for the health of the patient but for the doctors as well, thus creating a relationship for better decision making for everyone that is ultimately affected. Matusitz and Spear (2014) state, “doctors who give patients personal health care communication display a communication style that is credible, clear and ethical-all ingredients necessary for better understanding of health care outcomes” (p. 254). By looking at the way healthcare is communicated between doctor and patients is critical to not only the recovery of the patient but to the wellbeing of the doctors too.
Understanding a patients’ perspective is seen to various degrees, however, according to Chadwick and Lown (2016), “Doctors have to deal with a wide range of conditions varying in clinical severity and also in emotional valence. What they all require is respect, attentive listening, simple courtesy, and kindness,” (p. 583). This is ultimately the end goal for everyone involved.
The establishment of dialogical ethics, according to Arnett, Harding-Fritz, and Bell (2008), “listens to what is before one, attends to the historical moment and seeks to negotiate new possibilities,” (p. 95). Do No Harm, is a brain surgeons perspective by, Dr. Henry Marsh, (2016) about the care he gave to his patients. By the end of the book, one sees the relational care that he gave his patients, especially a patient he called David, “to stand over your dying patient would be as inhuman as the long hospital corridors,” (Marsh, 2016 p. 151). The compassion that has grown in the medical field helps to humanize doctors from a patients’ perspective, creating an understanding of the good and therefore learning from each other.
This study provides an insight into the perspective of a doctor and how the medical profession has evolved into a more compassionate equal role of individuality. My recommendation would be for individuals to engage doctors as people and being proactive with questions regarding treatment, to create a mutual understanding of compassion and care to remember everyone is human, however, we all have to hold ourselves responsible for our lives.
I have often heard the saying, “history repeats itself,” however, it is up to us to understand and guide the type of communication we want. We often speak of the negative that transpires in our lives, yet what are we doing to ensure that something positive comes from actions regarding our care? Incorporating listening skills from both, doctors and patients will enhance our quality of care, what our expectations for care and the guidelines that doctors recommend. Being attentive to both sides will create a better understanding from both doctors and patients.
If patients continue to disregard the suggestions of doctors for better care of ourselves us as individuals are only to blame. However, we leave that burden to those that are left to care for or mourn us. The responsibility lies on both the doctors and patients directly involved.
Suggestions for Future Research
This case study creates an opening for individuals with family members that are unable to speak or care for themselves, such as infants or elders. Communication is not always easy, however, if we take the time to understand the dialogue of others we can create a better pathway to understand an individual’s care or the perspective of a doctor.
Understanding the level of difficult care will also enable a better sense of communication between doctor and patients, to understand cultures that different or language barriers as well as religious beliefs will help in understanding how important the role of doctor and patient relationship is when it comes to care.
Arnett, R.C., Harden-Fritz, J. M. & Bell, L. M. (2008). Communication ethics literacy: Dialogue and difference. Los Angeles: Sage.
Chadwick, R. J., & Lown, B. A. (2016). Ethics and communication skills: What do we need to do to sustain compassionate medical care?. Medicine, 44(Ethics and Communication Skills), 583-585. doi:10.1016/j.mpmed.2016.07.003
Larner, G. (2015). Dialogical Ethics: Imagining the Other. Australian & New Zealand Journal Of Family Therapy, 36(1), 155-166. doi:10.1002/anzf.1093
Littlejohn, S. W. & Foss, K. A, (2011). Traditions of Communication Theory. Theories of Human Communication 10th ed. Long Grove, IL: Waveland Press, Inc.
Marsh, H. (2016). Do no harm: stories of life, death, and brain surgery. New York: Picador.
Matusitz, J., & Spear, J. (2014). Effective Doctor–Patient Communication: An Updated Examination. Social Work In Public Health, 29(3), 252-266. doi:10.1080/19371918.2013.776416