The doctor-patient relationship impacts the success of treatment and caring much. Currently, the traditional patient-doctor encounter and relationship are challenged by care service demand, the emerging technologies, and the COVID-19 pandemic.
Patients expectations during an encounter with a doctor (Delbanco, 1992) are:
- Patients want to understand the competence and efficacy of their doctors.
- Patients want to understand how their illness or treatment will affect their lives,
- Patients often worry that their doctors are not telling them everything they want to know.
- Patients want doctors to focus on their pain, physical discomfort, and functional disabilities.
- Patients want to discuss if their illness will affect their family, friends, and finances.
- Patients worry about their future.
- Patients worry and want to learn how to care for themselves away from the clinical setting.
- Patients want to be able to check the health care system effectively and to be treated with dignity and respect.
When the doctor-patient relationship includes competence and caring communication, there will be better adherence to treatment; patients will be more likely to be satisfied with the care received and can achieve better outcomes and quality of life.
How can information technology help build a doctor’s competence? IoT has proved its capability of improving the accessibility of healthcare services. How can IoT help caring communication between doctors and patients?
There are 3 Patient-Doctor Relationship Models:
- Activity-Passivity Model: it is most appropriate and often seen in emergencies. The patient seeks help and information, and the doctor provides care decisions, actively treats the patient, the patient passively accepts, and has little control.
- Guidance-Cooperation Model: this is based on the theory ‘doctor knows best’, it is the most common in current medical practice. In this model, the doctor recommends a treatment plan and the patient accepts in a cooperating way.
- Mutual Participation Model: the doctor and patient share information and responsibility for making decisions and planning treatment and recovery. Some have recommended that this is the most appropriate model for chronic disease management.
The implementation and adoption of The Mutual Participation Model heavily rely on clinical data interoperability, interpretation, and sharing in a meaningful and sensible way between the doctor and the patient and their families.
I completely agree that the Mutual Participation Model is the ideal model. I also think that part of the sharing information and responsibility is the idea of agreeing on some patient goals, if appropriate. Yes, in a way, this is using guilt or pressure as a motivator. So, in stead of an orthopaedic surgeon simply referring a patient to Physical Therapy, why not go the extra step and agree on some goals for walking distance or strength increase, or even weight loss? Treating the patient with the disease would seem to lead us in this direction.