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Existential concerns manifest themselves emotionally in patients. Emotions tend to be transferred between patient and doctor but the underlying existential concerns may remain hidden and obscure for both. If doctors understand that there are always existential concerns behind patients' inquiries it becomes easier to relate to the patient's feelings in an interested and curious way. Ultimately this benefits both doctors and patients. We have observed five existential human concerns leads to strong emotions (1. death, 2. thrown-ness, 3. aloneness, 4. choosing (the imperative of choice) and 5. meaninglessness (the absence of objective meaning).

Objective: Continuity of care is a long-standing feature of healthcare, especially of general practice. It is associated with increased patient satisfaction, increased take-up of health promotion, greater adherence to medical advice and decreased use of hospital services. This review aims to examine whether there is a relationship between the receipt of continuity of doctor care and mortality., Design: Systematic review without meta-analysis., Data Sources: MEDLINE, Embase and the Web of Science, from 1996 to 2017., Eligibility Criteria for Selecting Studies: Peer-reviewed primary research articles, published in English which reported measured continuity of care received by patients from any kind of doctor, in any setting, in any country, related to measured mortality of those patients., Results: Of the 726 articles identified in searches, 22 fulfilled the eligibility criteria. The studies were all cohort or cross-sectional and most adjusted for multiple potential confounding factors. These studies came from nine countries with very different cultures and health systems. We found such heterogeneity of continuity and mortality measurement methods and time frames that it was not possible to combine the results of studies. However, 18 (81.8%) high-quality studies reported statistically significant reductions in mortality, with increased continuity of care. 16 of these were with all-cause mortality. Three others showed no association and one demonstrated mixed results. These significant protective effects occurred with both generalist and specialist doctors., Conclusions: This first systematic review reveals that increased continuity of care by doctors is associated with lower mortality rates. Although all the evidence is observational, patients across cultural boundaries appear to benefit from continuity of care with both generalist and specialist doctors. Many of these articles called for continuity to be given a higher priority in healthcare planning. Despite substantial, successive, technical advances in medicine, interpersonal factors remain important., Prospero Registration Number: CRD42016042091., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Patients may be accompanied to the pain clinic consultation and these accompanying persons are relevant in the communication process., Aims: We sought to characterize if patients were accompanied and by whom to the pain clinic. We also wished to determine the accompanying persons influence on the doctor-patient interaction. This has not been studied previously in this clinical setting., Methods: Local ethics committee approval followed by written informed consent was obtained. Patients attending the pain clinic for the first time and review patients were included (n = 219)., Results: Twenty-one percent of patients (n = 46) were accompanied. Adult accompanied by spouse 19 (41.3 %) and adult child accompanied by parent 18 (39.1 %) were the most common dyads. The accompanying person's role was most frequently described by doctors as an advocate for the patient 30/46 (65.2 %) [for an adult accompanied by spouse (63.1 %)]. The influence of the main accompanying person on the patient doctor encounter was described as positive [adult accompanied by spouse (78.9 %)] [(adult accompanied by parent (94.4 %)]., Conclusions: Patients are accompanied to the pain clinic with a typically positive influence on doctor patient relationship and communication. Awareness of these issues is important in good communication in the pain clinic.

The character of medicine has changed over the last 100 years such that medicine is more interested in diseases than the people who suffer from them. Despite notable efforts to address this, the medical humanities do not challenge doctors' fundamental view of the world. Students adopt a metaphysic of physicalism during basic science training that gets carried into medical training. While necessary for medical science, physicalism is insufficient for clinical care. Physicalism offers no foundation for the sine qua non of medicine, the doctor-patient relationship. The character of medicine will not see a renewed interest in humanity until educators address the insufficiency of physicalism for clinical care, and clinicians partner with experts in the humanities to build a sui generis philosophy of medicine., (© 2014 John Wiley & Sons, Ltd.)

Background. The Patient-Practitioner Orientation Scale (PPOS) was originally developed to compare doctor's and patient's consensus regarding patient centeredness. Research assumed PPOS measurements to be comparable across different groups of participants, however, without assessing the actual validity of this assumption. In this study, we investigate the psychometric properties and measurement invariance of a short version of the German translation of the PPOS. Methods. Based on a cross-sectional survey of N = 332 medical students, we present a short version of the German Patient-Practitioner-Orientation Scale (PPOS-D6) and examine its psychometric properties as well as measurement invariance across participants with varying levels of medical experience and gender using multigroup confirmatory factor analyses. Results. Results indicate that PPOS-D6 provides valid and reliable measurements of patient-centeredness that are invariant across participants with different medical experience. Preliminary results also suggest invariance across gender. Conclusion. PPOS-D6 is a suitable and efficient measure to compare group-specific attitudes towards the doctor-patient interaction. Additional research on convergent and discriminant validity and divergent study samples is advised. [ABSTRACT FROM AUTHOR]

Background: Rapid changes in healthcare delivery system & socio-political climate have resulted in considerable strain on Doctor-patient relationship. Doctors' role is to install positive energy within the patient, through which sick people find relief from suffering. Without it, there continues to be more confusion, fear, and doubt. Future doctor should show compassion, be open, honest, & admits when he is unsure. Objective: This study aims to understand the social dimensions of Iraqi Doctor misbehavior & mal-communication with patients. Subjects & Methods: A cross sectional study, with a tool consisting of two sketch Drawings representing an agonizing misbehavior scenario for a female gynecologist encountering a pregnant patient, & a male orthopeditian encountering a disabled male patient. Scenarios were presented to a convenient sample of 155 Iraqi Doctors, pooled during (2012-2014) in Baghdad, striking their feelings, to generate rich comments. Results: About two thirds of Doctors were females, and the majority was non specialists. Only 7.1% of Doctors (with significant gender difference), offered an excuse for the misbehavior. Around 80% of Doctors expressed patient sympathy. Scenario understanding showed significant Doctors' gender difference. Two thirds of Doctors stated reasons & suggested solutions for the misbehavior. Main reasons stated were: commercialization of medicine (23.8%), loss of today's Doctor humanity (18.1%), and profession power & ability to threat (15.2%). Conclusion: Although Doctor-patient misbehavior is not un-prevalent, most Iraqi Doctors disagree with it. The majority express professional sympathy. Less than tenth of Doctors stand by misbehavior, trying to give excuses. Commercialization of medicine, loss of Doctor's humanity, professional power, & mal-communication are emerging challenges for future Iraqi Doctor-patient relation. [ABSTRACT FROM AUTHOR]

Objective: In medicine, numerous commentaries implore clinicians (e.g., physicians, physician assistants, nurse practitioners) to display more humility. However, given the complex power dynamics between patients and clinicians, one should not presume that patients desire and appreciate humble clinicians. This paper examines the relationship between clinician humility and patient outcomes, and aims to provide empirical evidence for the significance of clinician humility.Methods: In two studies, patients (N = 497) recalled their most recent visit to a clinician through an online survey platform (Qualtrics). Patients rated their clinician's humility, satisfaction and trust with their clinician, and health status. They also provided demographic information (e.g., gender, race, subjective SES), details about their clinician (e.g., gender, race, professional status) and information about their last medical visit with this clinician (e.g., purpose of visit, wait time during visit).Results: Through hierarchical multiple regression, we demonstrated that clinician humility positively predicted patient satisfaction, trust, and self-report health (only in Study 2) above and beyond patient, clinician, and visit characteristics.Conclusion: The results demonstrated that clinician humility can predict important patient outcomes above and beyond objective characteristics of the medical interaction.Practice Implications: These findings may shape clinician-patient interactions by validating the pursuit of humility during medical encounters. [ABSTRACT FROM AUTHOR]

Background: Rapid changes in healthcare delivery system & socio-political climate have resulted in considerable strain on Doctor-patient relationship. Doctors' role is to install positive energy within the patient, through which sick people find relief from suffering. Without it, there continues to be more confusion, fear, and doubt. Future doctor should show compassion, be open, honest, & admits when he is unsure. Objective: This study aims to understand the social dimensions of Iraqi Doctor misbehavior & mal-communication with patients. Subjects & Methods: A cross sectional study, with a tool consisting of two sketch Drawings representing an agonizing misbehavior scenario for a female gynecologist encountering a pregnant patient, & a male orthopeditian encountering a disabled male patient. Scenarios were presented to a convenient sample of 155 Iraqi Doctors, pooled during (2012-2014) in Baghdad, striking their feelings, to generate rich comments. Results: About two thirds of Doctors were females, and the majority were non specialists. Only 7.1% of Doctors (with significant gender difference), offered an excuse for the misbehavior. Around 80% of Doctors expressed patient sympathy. Scenario understanding showed significant Doctors' gender difference. Two thirds of Doctors stated reasons & suggested solutions for the misbehavior. Main reasons stated were: commercialization of medicine (23.8%), loss of today's Doctor humanity (18.1%), and profession power & ability to threat (15.2%). Conclusion: Although Doctor-patient misbehavior is not un-prevalent, most Iraqi Doctors disagree with it. The majority express professional sympathy. Less than tenth of Doctors stand by misbehavior, trying to give excuses. Commercialization of medicine, loss of Doctor's humanity, professional power, & mal-communication are emerging challenges for future Iraqi Doctor-patient relation. [ABSTRACT FROM AUTHOR]

Introduction. Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor-patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor-patient relationship. Methods. A descriptive, cross-sectional study design with convenience (nonprobability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or "HOs'' (recent graduates doing their 1 year long internship) and postgraduate trainees or "PGRs'' (residents for 4-5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor-patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results. A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P >0:05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson's burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion. Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor-patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced. [ABSTRACT FROM AUTHOR]

God has chosen special persons to take care of the physical pains and sufferings of man and such persons are known as doctors. But recently countrywide dissatisfaction on the major pillar of the medical services raises number of questions. In this present article authors have tried to find out the related factors with the changing scenario of doctor-patients relationship from India's prospective. In the ancient India, doctors were enjoying the highest level of respect in the society because of the attitude and activity towards the patient. In the last decade of the 20th century and beginning of 21st century, a chronic dissatisfaction began to settle over the relationships between doctors and patients. High level of corruption in the health care industry, inequity in health care delivery, technological development in medical science, growth of health insurance, patient's desire in share decision making, information technology development are few factors behind changing doctor-patient relationship. If physicians take a little more time in reassuring patients in the old fashioned way, this will restore the deteriorating relationship. [ABSTRACT FROM AUTHOR]

Online social networking is an immature, but rapidly evolving industry of web-based technologies that allow individuals to develop online relationships. News stories populate the headlines about various websites which can facilitate patient and doctor interaction. There remain questions about protecting patient confidentiality and defining etiquette in order to preserve the doctor/patient relationship and protect physicians. How much social networking-based communication or other forms of E-communication is effective? What are the potential benefits and pitfalls of this form of communication? Physicians are exploring how social networking might provide a forum for interacting with their patients, and advance collaborative patient care. Several organizations and institutions have set forth policies to address these questions and more. Though still in its infancy, this form of media has the power to revolutionize the way physicians interact with their patients and fellow health care workers. In the end, physicians must ask what value is added by engaging patients or other health care providers in a social networking format. Social networks may flourish in health care as a means of distributing information to patients or serve mainly as support groups among patients. Physicians must tread a narrow path to bring value to interactions in these networks while limiting their exposure to unwanted liability. [ABSTRACT FROM AUTHOR]

The lack of adherence to treatment of chronic cardiovascular disease is a clinical problem. Goes beyond doctor-patient relationship to what's new in social and public health worldwide. There is no one solution, but the potential for broad collaboration to resolve it with doctors, patients and facilities that provide organized community action. The Mexican Society of Cardiology aware of its leading role in the affair has taken the initiative to master the problem. This article is the initial report containing a review of the literature and a qualitative research study. Has focused on the interpretation of statements organized discussion "on purpose" at the recent Congress of Cardiology. Stresses the need to organize, promote the culture of health, acting in the rehabilitation of the doctor patient relationship according to the new demands of modernity and radical changes. [ABSTRACT FROM AUTHOR]

Abstract: Background: Bringing the doctors under the ambit of Consumer Protection Act has made an impact on doctor-patient relationship. There has been an increase in legal cases of medical negligence in the recent past. This article provides practical information on medical negligence. Methods: Complaints received at Army Headquarters were studied to understand the factors involved in medical negligence. Result: Various aspects of medical negligence including doctor-patient relationship in the military set up have been discussed. Preliminary measures to be taken to avoid cases of negligence are enumerated. Conclusion: Good communication skills to build a rapport with the patient is the key to avoid majority of the complaints. The doctor must pay due courtesy, respect and care to the patient besides maintaining medical records scrupulously. [Copyright &y& Elsevier]

Background: Emotional Intelligence is the ability of a person to understand and respond to one's own and others' emotions and use this understanding to guide one's thoughts and actions. To assess the level of emotional intelligence of medical students in a medical college in Chennai and to explore their understanding of the role of emotions in medical practice. Methods: A quantitative, cross sectional, questionnaire based, survey was conducted among 207 medical students in a college in Chennai, India using the Quick Emotional Intelligence Self Assessment Test and some hypothetical emotional clinical vignettes. This was followed by a qualitative moderated fish-bowl discussion to elicit the opinion of medical students on role of emotions in the practice of medicine. Results: The mean score of Emotional Intelligence was 107.58 (SD 16.44) out of a maximum possible score of 160. Students who went to government schools for high school education had greater emotional intelligence than students from private schools (p = 0.044) and women were more emotionally intelligent in their response to emotional vignettes than men (p = 0.056). The fish bowl discussion highlighted several positive and negative impacts of emotions in clinical care. The students concluded at the end of the discussion that emotions are inevitable in the practice of medicine and a good physician should know how to handle them. Conclusions: Medical students, both men and women, had good level of emotional intelligence in the college that was studied. Students from collectivist social settings like government high schools have better emotional intelligence, which may indicate that a collectivist, community oriented medical education can serve the same purpose. Though students have diverse opinions on the role of emotions in clinical care, cognitive reflection exercises can help them understand its importance. [ABSTRACT FROM AUTHOR]

Background: Electronic patient portals provide a new method for sharing personal medical information with individual patients.Objective: Our aim was to review utilization patterns of the largest online patient portal in Canada's largest city.Methods: We conducted a 4-year time-trend analysis of aggregated anonymous utilization data of the MyChart patient portal at Sunnybrook Health Sciences Centre in Ontario, Canada, from January 1, 2012, through December 31, 2015. Prespecified analyses examined trends related to day (weekend vs weekday), season (July vs January), year (2012 vs 2015), and an extreme adverse weather event (ice storm of December 20-26, 2013). Primary endpoints included three measures of patient portal activity: registrations, logins, and pageviews.Results: We identified 32,325 patients who registered for a MyChart account during the study interval. Time-trend analysis showed no sign of attenuating registrations over time. Logins were frequent, averaged 734 total per day, and showed an increasing trend over time. Pageviews mirrored logins, averaged about 3029 total per day, and equated to about 5 pageviews during the average login. The most popular pageviews were clinical notes, followed by laboratory results and medical imaging reports. All measures of patient activity were lower on weekends compared to weekdays (P<.001) yet showed no significant changes related to seasons or extreme weather. No major security breach, malware attack, or software failure occurred during the study.Conclusions: Online patient portals can provide a popular and reliable system for distributing personal medical information to active patients and may merit consideration for hospitals. [ABSTRACT FROM AUTHOR]