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–
Engaging in conflict situations.
–
Underestimating difficult patients, with increased psychogenic
tendencies.
–
Polimedication as an expression of the doctor’s
submission to
patient’s insistence.
Role conflicts in the doctor/patient relationship:
–
Psychological resistance of some patients to the doctor’s authority.
–
Affective ambivalence of the patient.
–
Refusal or inability to communicate of certain patients.
Deficiencies in doctor-patient communication:
–
Failure to appropriately greet the patient, introducing oneself and
explaining one’s actions.
–
Failure to get easily accessible information, mainly due to fears
and expectations.
–
Accepting imprecise information, failure in seeking clarifica-
tions.
–
Failure to verify with the patient
what the doctor understood
from the situation.
–
Failure to elicit questions or to appropriately answer to questions
–
Neglecting obvious clues or clues not provided verbally or in a
different manner by the patient.
–
Avoiding information concerning the patient’s personal, family,
social status, including problems in these areas.
–
Failure to elicit information about the patient’s feelings and the
perception of the illness.
–
Directive style with closed questions, frequent interruption and
failure to make the patient speak freely.
–
Rushed focusing without testing theories.
–
Failure to provide appropriate information
concerning the diag-
nosis, treatment, side effects or prognosis, or in verifying the patient’s
understanding of these issues.
–
Failure to understand the patient’s viewpoint.
–
Poor comforting.
The
goal
of any patient-doctor relationship should be one of mutual
respect
and collaboration, working together to achieve your best possi-
ble medical outcomes. Most of the time that is exactly what happens.
But sometimes the relationship goes away, and that may require repai-
ring the patient-doctor relationship.
59
Sometimes the problems are the doctor's fault. From the first mee-
ting,
he may have been abrupt, or arrogant, or he simply has a lousy bed-
side manner. If that's the case, there is nothing to be repaired. It's just the
doctor's personality.
However, sometimes the problem is caused by the patient herself.
She may have had a good relationship with her doctor for a period of
time, but something happened to make her
doctor subsequently balk at
providing additional care. In that case, she may choose to try to repair
her relationship with her doctor.
If this is your circumstance, you'll need to assess whether the prob-
lem was caused by you or your doctor. If you caused it, then
the steps
below will help you work to repair the relationship. If not, if you feel the
deteriorated relationship is your doctor's fault, then you'll need to decide
whether it's worth repairing, or more to the point, possible to repair.
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