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The Doctor And You: A Partnership For Health

Women that are diagnosed with breast cancer need to have experienced, qualified and highly professional medical experts to help inform and guide them each step of the way. Researching different physician’s practices and methods of treatment as well as learning how to communicate with a medical team is all part of the process. Finding the doctor that provides competence and a sense of confidence and hope for the patient is one of the most important aspects of becoming emotionally and mentally prepared for the difficult choices and medical treatments that lie ahead.

Styles of Physician-Patient Relationships

Two distinct types of physician-patient relationships have been recognized. These include a physician-centered interaction and a patient-centered interaction. In the physician-centered interaction, the doctor is provides information, seeks details, provides statistics about different treatment options and determines a treatment course. He or she is the expert and provides a dominant role in developing the treatment plan. This is the traditional style used in western medicine, such as the United States, and may be preferred by women who are overwhelmed or are experiencing difficulty when making decisions. 1

The opposite of this approach to physician-patient communication is a patient-centered approach. This style is similar to the other in that the doctor may make suggestions, provide information and expert opinions to the patient, but the patient ultimately makes the decision. This is preferable for many that have experienced a cancer diagnosis with a loved one and have some understanding of how treatment options will impact their lives and the lives of their families. The patient may occasionally take the lead in making decisions, such as requesting a second opinion or asking for additional testing. This method empowers the patient and makes him or her part of the treatment team rather than a passive bystander. 2

Communication

As a patient it is important to have the time that you need to discuss concerns, explore options and gather information from your healthcare provider.  In a study of 1486 patients who saw their primary care physician, it was determined that patients had greater satisfaction with their care when they were given more time to discuss their concerns than those who had insufficient time. The time that patients deemed necessary was based on the severity of the health concern for which they were being seen. 3

This research clearly indicates how important it is to patients that a doctor listens to them and gives them sufficient time to discuss all of their concerns thoroughly. Some clinics and specialists also provide additional means of communication via emails, nurse practitioner support and online education programs about various treatment concerns.

Prior Relationship

Having a primary care physician that you have established care with, who knows your medical history as well as some of your personality traits is important when they learn about your diagnosis. Having complete trust in your primary care doctor will give you complete confidence that they will refer you to the doctor that is best for you. In studies that tracked a doctor’s use of resources in ongoing patient care, it was found that the most effective and efficient use of medical tests, referrals and even medications were positively influenced by how long a doctor had been treating the patient prior to their cancer diagnosis. 4

Multidisciplinary Care Teams

Many hospitals and clinics now use a multidisciplinary care team approach when treating breast cancer. Occasionally, primary care physicians participate in their patient’s care on these teams. This allows the relationship of the patient with the primary care physician to continue while other team members take control of the care during different aspects of treatment. This team may include mental health professionals and a variety of other medical professionals to assist in every part of the patient’s care.

Patients should also be a part of their treatment team, being involved in as much decision making as possible. Finding a team of physicians that allow patients to do so may be difficult, but begins with researching each physician and their practices. If a primary care physician is already established, he or she will typically make referrals to specialists that have similar patient management styles.

In essence, the role of the primary care physician may extend beyond that of a health care provider. He or she may be an advocate for the patient between different physicians or when the patient feels like they are not being heard. The importance of a primary care physician cannot be underestimated, especially when a patient is faced with the diagnosis of breast cancer.5

References

1, 2 Childress, James, F., & Siegler, M. (1984). Metaphors and models of doctor-patient relationships: Their implications for autonomy . Theoretical Medicine And Bioethics , 17-30.

3 Lin, C.-T., Albertson, G. A., Schilling, L. M., & etal. (2001). Is Patients’ Perception of Time Spent With the Physician a Determinant of Ambulatory Patient Satisfaction?. Archieves Of Internal Medicine , 1437-1442.

4 Hjortdahl, P., & Borchgrevink, C. F. (1991). Continuity of care: influence of general practitioners’ knowledge about their patients on use of resources in consultations. 1181-4.

5 Ganz, P. A. (1995). Advocating for the Woman with Breast Cancer. CA: A Cancer Journal for Clinicians , 114-126.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.