The experience of the long-term doctor-patient relationship in consultant nephrologists.

Abstract

There is evidence to suggest that the long-term doctor-patient relationship is crucial in the management of chronic illness such as chronic kidney disease. While previous research has focused on patient views of the doctor-patient relationship, research exploring the doctor's experiences of this unique dynamic is lacking, leading to a gap in our understanding. Therefore, an enhanced appreciation of the experience of the doctor is important and could have potential implications for medical training and service organisation. In this paper, we report the first known study exploring the experience of consultant nephrologists in the long-term doctor-patient relationship. Seven male consultant nephrologists (mean age of 48 years) took part in semi-structured interviews, and data were analysed using interpretative phenomenological analysis (IPA). Three main themes were identified from the analysis: 'Defining my professional identity', 'Relating to the patient' and 'Coping with the job'. Participants had difficulty in defining their role as doctors, discussing themselves as being more than a doctor and comparing themselves with other medical specialties to help them define their identity. Although participants enjoyed forming long-term relationships with patients and the closeness this involved, they discussed the acute scenarios of saving lives as the most rewarding aspect of their job and used coping mechanisms that enabled them to remain detached in the relationship.