Drjunewilliamscolsma- Doctor-patient relationship and Patient Interview

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Doctor-Patient Relationship and Initial Patient
Interview

• Dr June Williams Colsman M.D. of Medicine

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Physician
Some patients, though conscious that their
condition is perilous, recover their health
simply through their contentment with the
goodness of the physician.
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Placebo Effect
Placebo Effect is a combination of a
psychological expectation blended with a neuron
chemical response that transforms an anticipated
effect into a real effect
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Placebo Response
At least 20-30 of patients have been shown to
respond to treatment with placebo Placebo pain
response can be blocked by naloxone which
suggests it is mediated by the endogenous opioid
system
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Transference
Expectation, beliefs and emotional responses that
the patient brings to the doctor-patient
relationship based on important relationships in
the patients past
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Positive Transference
Patient views doctor as good and has confidence
in his or her ability Can lead to over
idealization and tremendous disappointment when
doctor cant solve all problems or is not always
available.
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Negative Transference
Patient views doctor as harsh punitive parent or
authoritative figure who doesnt care about well
being and patient may be non-compliant. Patient
with experience with untrustworthy parent may
seek many consultations and may be provocative to
doctors
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Countertransference
Refers to doctors reaction towards patient based
on their own earlier experience Doctors can feel
guilty when they are unable to help
patient Doctor may have feelings towards patient
who remind them of close relative or friend.
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Models of Doctor Patient Relationship
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Empathy
The ability to momentarily experience the the
feelings of another person ( put yourself in
another persons place. Transiently experience
feelings of the patient and use those feelings to
gain understanding of the the patients
subjective experience Communication of that
understanding to the patient
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Empathy -Components
Transiently experience feelings of the patient
and use those feelings to gain understanding of
the the patients subjective experience Communicat
ion of that understanding to the patient
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Clinical Interview
The Interview Process The Interview Process INE
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Clinical Interview
Be Polite Introduce yourself to patient Make the
patient comfortable Initial Question-Invite the
patient to tell you how he or she came to be in
the hospital (chief complaint ).