Communication models for doctor-patient relationships

Progress in medical science, technology and the multidisciplinary approach over the last half century has made it possible for people to live longer and to remain in good physical condition [1]. However, these benefits are sometimes only physical. Many studies have demonstrated that although patients are grateful for restored physical health, they have suffered psychologically from the lack of direct contact with their doctor which has been replaced by an anonymous team of specialists and machines. The old style doctor-patient relationship has been discarded; the patient is no longer a whole person but has become a list of scan and test results. Is it any wonder that patients feel that their doctor is not really interested in them as people [2–4]. In general, medical training does not include or barely touches on the importance of communication in the doctorpatient relationship focusing instead on the physical illness and not the patient [5, 6]. The communicative relationship between doctor and patient is inevitably conditioned by numerous variables such as the time and space available, the ability and psychological willingness of the doctor to face bad news for the patient and the patient’s ability to take part in a psychologically intense meeting. The relationship is further conditioned by the medical discipline involved, for example intensive care, paediatrics, oncology, ophthalmology, surgery, dermatology, palliative care, to name just a few of the specialist disciplines which all represent different experiences for the patient, different diagnostic and therapeutic interventions which often are diametrically opposed and which have a notable influence on the doctor-patient relationship and the method of communication. Unfortunately, the so called spending review has and will further reduce human resources which translates into the doctor having less time to dedicate to the fundamental moments of treatment such as listening, understanding and having a dialogue with the patient.