What's important in the doctor-patient relationship?

Abstract

While most of the published research into the doctor-patient relationship focuses on communication skills and behaviours, the paper by Dr Lings and colleagues (April 2003 JRSM1) provides further insight into the non-behavioural aspects of these relationships. Their findings point to ‘liking’ as a key factor of the doctor-patient relationship. This concept, however (or ‘interpersonal attraction’ as it is sometimes called), is not new to the realms of psychological research on the doctor-patient relationship. Like and Zyzanski2 found positive associations between how much the physician liked the patient and both the doctor's and the patient's satisfaction with the visit. Hall et al. 3 expanded the investigation of doctors' liking of patients and again reported a positive association between physician liking and patient satisfaction as well as finding that physicians report higher liking of patients who were male and in good health. This might lead to the notion that liking and satisfaction are synonymous, however Hall et al. 4 now suggest that liking is not simply redundant with satisfaction and is indeed an important psychological characteristic of the doctor-patient relationship. They also reported a reciprocity in terms of liking, whereby how much each liked the other was related to how much each was liked. Given the evidence that liking and satisfaction may be single entities, 4 where does that leave rapport? If liking is being defined as ‘having an easy and comfortable relationship with the doctor’1 and it includes ‘warmth, respect, interest and enthusiasm for seeing the patient’, 2 how is this different from the concept of rapport? Is liking merely redundant of rapport or is liking at the crux of establishing a good rapport between doctors and patients? Determining the relation between liking and rapport may be another step in the process of clarifying the non-behavioural aspects important in doctor-patient communication.