Doctor-patient Relationship Research Articles

Once Upon a Time: Storytelling to Connect with Your Patients

Storytelling is a form of communication through which we can help people cope with and reframe Illnesses, treatment, or death by providing meaning and comfort. Engaging patients through storytelling can make medical interactions more effective and meaningful. Doctors can use several strategies to incorporate storytelling into their practice to enhance patient communication. The potential beneficial effects of telling a story have been recognized in many cultures and have received attention from philosophers, social scientists, and medical practitioners. The author discusses how stories can embellish the doctor-patient relationship.

Patient and healthcare provider perspectives on a digital first general practice: mixed-method study

Abstract Background General practitioners (GPs) are facing an increased workload as a result of an aging population and a growing prevalence of chronic diseases. Utilizing eHealth may help to enhance healthcare accessibility and reduce costs. A digital platform was developed that integrates eHealth into the organizational aspects of general practices. This study aims to provide insight into the experiences of patients and healthcare professionals with this new, digital way of working. Methods A mixed-method study was conducted in three Dutch general practices working with the digital platform. The digital platform focuses on digital communication and remote healthcare delivery in primary care. Primary outcomes included acceptability, the implementation process, suggestions for improvement, and facilitators and barriers for future implementation. Patient perspectives were identified through online questionnaires and focus groups, and healthcare professionals’ experiences were explored through in-depth interviews. Results Five focus groups and ten in-depth interviews were held. The questionnaires were completed by 616 patients. Patient acceptability of the care concept was high (M = 3.9, SD = 1.0; on a scale from 1-5) and they were satisfied with received care (M = 30.1, SD = 3.4; on a scale from 8-32). Regarding the perceived quality of consults, patients were positive about the longer duration of physical consults (i.e., 20 instead of 10 minutes). Some participants indicated a less personal doctor-patient relationship, because care was provided by various GPs. Conclusions Overall, patients and healthcare professionals were positive about the digital platform. The study gives insights into how to improve the care concept, e.g., how to enhance the doctor-patient relationship. Key messages • Digital first general practices that integrate eHealth into the practice’s organizational aspects of are considered acceptable by patients and healthcare professionals. • Digital first general practices can help to improve healthcare accessibility for both patients and healthcare professionals.

Revisiting the conceptualisation and implications of medicine's 'hidden curriculum'.

In medical training and practice, our professional attributes, attitudes, perceptions, character traits and identities are fundamentally shaped by our lived experiences and observations in clinical and para-clinical settings instead of being inculcated through formal curriculum or classroom teaching. For instance, clinical acumen, communication skills and bedside manners are learnt through role modelling and experiential learning in the course of clinical rotations. Likewise, one's attitudes, professional behaviours and inclinations are often also influenced by direct/indirect observations of the actions of others in the medical fraternity in various clinical and non-clinical settings. This is also what is often termed as the 'hidden curriculum' of medicine. In this article, we sought to provide a practical conceptualisation of the hidden curriculum in medical training, which we describe as lived experiences and personal observations of medical trainees and residents in clinical and para-clinical spaces, which shape their perceptions of the medical profession (vocational identity and purpose), patients (patient-physician relationship) and colleagues (intra- and inter-professional relationships), with downstream implications on physician well-being and clinical decision-making. Although this idea of a 'hidden curriculum' has conventionally carried predominantly negative connotations in medical literature, we suggest that it is an inevitable part of medical education and practice, which, through deliberate regulation, can potentially be shaped to create more positive and meaningful effects in the professional development of medical trainees.

Reevaluating Informed Consent: Integrating Shared Decision-Making into Spinal Surgery for Better Patient Outcomes.

Narrative review. The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery? N/A. SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, alternatives, and postoperative expectations. Informed consent is a vital component of this process, ensuring that patients are fully informed and empowered to make decisions based on their values and preferences. This review highlights the current state of informed consent within the context of SDM in spine surgery and explores how enhancing this process can improve patient outcomes, reduce dissatisfaction, and decrease litigation. By emphasizing patient autonomy and improving the quality of risk communication, SDM fosters better physician-patient relationships and more positive clinical outcomes. Orthopaedic surgery and neurosurgery are highly litigated specialties, with failure to obtain informed consent frequently cited in lawsuits. These legal challenges are costly and time-consuming for both physicians and patients. Integrating SDM into the informed consent process can help mitigate these issues, leading to improved patient satisfaction and fewer legal disputes.

Core psychosocial insights, challenges, and opportunities in the orthopedic surgery care of children and adolescents

Purpose: This is the second phase in an investigation of the psychosocial impact of orthopedic surgery on adolescents. What are the core psychosocial factors that shape the experience of adolescent patients aged 11–18 who are undergoing orthopedic surgery? Methods: Two 43-question surveys (preoperative and postoperative) were developed as modified versions of the survey used in phase 1. The preoperative survey was administered 2 weeks before surgery. The postoperative survey was administered 6 weeks later. Responses were collected from free-response and Likert-scale questions exploring patient–physician relationships, office visits/hospital stays, family, peers, academics, sports, and surgical expectations. The survey was administered prospectively to patients aged 11–18 undergoing limb lengthening/reconstruction, pediatric, spine, sports, or hand/upper extremity orthopedic surgery. In all, 135 patients were identified; 105 were enrolled and completed both surveys. Results: There were some statistically significant changes in responses to questions regarding office visits/hospital stays, patient–physician relationships, friends/community, academic performance, and expectations for surgical experience throughout the perioperative period. There were no statistically significant changes in responses to questions regarding the role of parent/family and sports. There was no statistically significant difference between the female and male genders or between age groups in any of the domains. Overall statistical significance in this study did not consistently correlate to clinical significance. Conclusion: Adolescents require psychosocial support from their surgeons, caregivers, and peers in addition to respect for their independence and personal needs. Level of evidence: Level II.

Capacity assessment for euthanasia in dementia: A qualitative study of 60 Dutch cases.

The number of patients with dementia who are granted euthanasia or assisted suicide (EAS) increases yearly in the Netherlands. By law, patients need to be decisionally competent or have an advance directive. Assessment of decisional capacity is challenging as dementia progressively affects cognitive performance. We aimed to assess qualitatively which factors, and how, influence the judgment of decisional capacity in EAS cases with dementia. We performed a qualitative study of 60 dementia EAS case summaries published by the Dutch regional euthanasia review committees between 2012 and 2021. Included reports were evaluated using the grounded theory approach. All quotes related to decisional capacity were coded independently by two researchers and compared in an iterative process to formulate an overarching framework on the assessment of decisional capacity. We selected 20 patients who had an advance directive and were judged to be decisionally compromised, as well as a selection of 40 EAS cases judged to be decisionally competent, half of which also had an advance directive (purposive sampling). Decisional capacity was present in every case report. Predefined, external criteria were rarely described explicitly, but physicians indirectly referred to the (cognitive) criteria set by Appelbaum and Grisso. Whether the thresholds for these dimensional criteria were met was influenced by six supporting factors (level of communication, psychiatric comorbidity, personality, presence of an advance directive, consistency of the request, and, finally, the patient-physician relationship) that also directly contributed to the judgment of capacity. The involved physicians and executed investigations were the two contextual factors providing a background. Decisional capacity regarding euthanasia is a multidimensional construct, often implicitly assessed and influenced by supporting and contextual factors. The subjectivity of the final judgment poses ethical and legal issues and argues for continuous quality improvement processes.

Patient-centered lean healthcare management from a humanistic perspective

BackgroundHealthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients’ emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model.MethodsThe study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach.ResultsEight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare’s focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture.ConclusionsThis research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries.

Relationally competent attitudes and actions: a systematic review of general practice literature

Objective To explore core elements from Teachers’ Relational Competence in general practice literature regarding building relationships in consultations, specifying actions doctors take to create and maintain relationship quality with patients. This systematic literature review aims to map and propose a similar framework for the doctor-patient relationship. Background The doctor-patient relationship, a well-researched yet complex field, often lacks clear descriptions. In recent definitions of patient-centred medicine, the responsibility of this relationship falls on the doctor, though how both relationship and responsibility is enacted needs clarification. Pedagogical literature on the student-teacher relationship provides a framework for relational competence, incorporating the needs and interactions between teacher and student and their alignment with institutional goals. Methods A systematic review of two databases yielded 1256 hits. After screening, 15 studies were included and assessed. A qualitative synthesis was conducted through iterative and thematic deductive analysis. Results Four relationally competent attitudes identified were: Attention to emotion, Devotion, Mentalization, and Time-oriented presence. Four relationally competent actions identitfied were: Being open, Attunement, Offering Support, and Using humor. Additionally, Trust and Continued connectedness were found as components of both attitudes and actions. Conclusion An explanatory framework for professional relational competence for GPs includes concrete actions and specific attitudes before and during consultations. These consist of four key attitudes and four categories of actions with several subgroups of actions. Two additional components to the framework was found.

Factors Affecting Satisfaction With the Process of Orthodontic Treatment in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife

Objectives: This study aims to determine the factors contributing to patient satisfaction with orthodontic treatment at Obafemi Awolowo University Teaching Hospital Complex. The specific objectives were to identify factors improving and negatively impacting patient satisfaction, and determine the level of patient satisfaction. Methods: A cross-sectional study design was employed, which involved patients attending the orthodontic clinic at Obafemi Awolowo University Teaching Hospital Complex. A self-administered questionnaire assessed patient demographics, satisfaction levels, and factors influencing satisfaction. Data analysis was performed using descriptive statistics, chi-square tests, and mean scores. Results: Of the 67 respondents, 91% reported satisfaction with their orthodontic treatment. The doctor-patient relationship received the highest mean satisfaction score, while psycho-social improvement received the lowest. Dissatisfied patients were predominantly females in the 21-30 age group. Factors such as dento-facial and dental function improvements significantly affected satisfaction levels. Conclusion: The majority of orthodontic patients at Obafemi Awolowo University Teaching Hospital Complex reported satisfaction with their treatment. Improving patient communication, managing expectations, and addressing dento-facial and dental function improvements can enhance satisfaction levels. Strengthening the doctor-patient relationship and optimizing clinic experiences can improve patient satisfaction.

When end of treatment situations challenge patient-centered care: a discussion paper proposing new theoretical insights

IntroductionAccording to the Institute of Medicine patient-centered medicine is one of the six crucial dimensions of health care quality. Although the patient-centered care model is widely recognized for its ethical underpinnings and effectiveness, its practical implementation still raises challenges, especially in end-of-treatment situations. This discussion paper offers an overview of the challenges facing the physician-patient relationship in end-of-treatment situations.MethodsWe developed three clinical vignettes and made some theoretical considerations about ethical issues related to the decision-making process leading to the end of treatment.ResultsWe identified two main challenges that end-of-treatment situations pose to patient-centered care: (1) when the patient’s autonomy challenges the best clinical treatment; and (2) when the proposed treatment (discontinuation of treatment) challenges the patient’s preferences.DiscussionsPatient-centered care supports personalized decision-making, in which the physician’s approach varies according to the patient’s situation and individuality. The idea of beneficence may change during care, because of acceptance of the patient’s principles or a change in the primary goal of care.

Impact of telehealth implementation on medical non-consultant hospital doctors training experience

Telehealth is defined as the provision of health care services over a distance. Major health systems, including outpatient clinics and check-ups alike, turned to telehealth and teleconsultation amid the COVID19 pandemic. There are many recognized advantages of telehealth and its increasing implementation, however, not much is known about the specific impact of remote consultation on the quality of non-consultant hospital doctors (NCHD) training experiences in medicine. This study aimed to gain rich descriptive insights into the specific impact of remote consultation on the quality of medical NCHD training experiences and their perceptions, through purposeful sampling. Data was collected via semi-structured virtual interviews of fifteen NCHD participants. The interviews were recorded, transcribed and analysed using thematic analysis. The collective transcripts were analysed using NVIVO data software for common themes. The themes identified suggested that there were both advantages and disadvantages to telehealth and its impact on training across a spectrum of entities including; doctor-patient relationships, peer relationships, service provision, work morale, working hours, clinical skills experience and general feedback as a trainee. NCHD perspectives expressed were mixed across all themes. Further research is recommended to advance understanding of the potential impact of telehealth on current and prospective doctors in training. With a greater understanding of general insights, future changes, including telehealth training programmes, could be implemented to build confidence and familiarity with telehealth utilization and potentiate its conceivable benefits.

Jehovah’s witnesses: Challenges in liver disease management and in liver transplantation

Patients of Jehovah’s witnesses faith who are in need of liver transplantation pose unique challenges. These patients should be seen at transplant centers with experience in caring for Jehovah’s witnesses to formulate careful pre, intra, and post operative strategies on an individualized basis with multidisciplinary input to mitigate the risk of bleeding complications and to prepare for potential catastrophic scenarios. In depth and individualized conversations about what constitutes acceptable bloodless transfusion strategies both for the patient and for the transplant center should begin as early as possible with an experienced coordinator or church liaison. A therapeutic physician patient relationship is vital to formulating a safe care plan and to understanding the spectrum of beliefs among Jehovah’s witnesses. There remains a paucity of data on disparities in liver care and outcomes in patients of Jehovah’s witnesses faith. Future research on liver diseases and liver transplantation in Jehovah’s witnesses should focus on creating registries of patient outcomes and of centers with experience.

Exploring Physicians' Perceptions of Digital Health's Impact on the Patient-Physician Relationship in the Primary Health Care Setting: Qualitative Descriptive Study.

Digital health has become essential for effective clinical practice. However, the successful adoption of digital health is dependent on the strength of the patient-physician relationship. The patient-physician relationship shapes the quality of care and impacts health care outcomes, especially in primary care. However, the impact of the increasing use of digital health on the patient-physician relationship is uncertain. This study aims to explore the types of digital health primary care physicians use and understand their impact on the patient-physician relationship from their perspective. This exploratory qualitative descriptive study used individual in-depth interviews guided by a semistructured topic guide. We purposively sampled physicians from 6 general primary care clinics in Singapore and used thematic analysis to identify emergent themes. We conducted 12 interviews. We found that primary care physicians in Singapore had minimal exposure to digital health beyond the scope of institutional implementation. The three key themes that emerged were as follows: (1) evolving roles of both physicians and patients; (2) impact on trust, knowledge acquisition, and longitudinal care; and (3) adoption and use factors of digital health impacting patient-physician relationships. The adoption and use factors comprised "social and personal," "technical and material," and "organization and policy" factors. The study identified that, while primary care physicians held mostly positive views on adopting digital health in improving the patient-physician relationship, they were concerned that digital health might erode trust, hinder proper knowledge acquisition, and reduce humanistic interaction. These concerns called for a nuanced approach to ensure that digital health would not compromise the patient-physician relationship. This could be achieved by ensuring that physicians possess the necessary skills, knowledge, and positive attitude, while health care organizations would provide robust IT capabilities and support. We recommend that education be refined and government policies on digital health adoption and use be revised to align with the goal of strengthening the patient-physician relationship.

The healing power of the doctor-patient relationship.

Humane and empathic care are quintessential to the medical profession. In this narrative, a psychiatrist reflects on a difficult patient encounter which highlights the influence of trauma on a patient with psychosis and how the doctor-patient relationship is paramount in the treatment of any illness.

A quasi-experimental study of trigger films for teaching the doctor-patient relationship

Background: It is challenging to teach the complexity of the doctor-patient relationship through attitude, ethics, and communication (AETCOM) modules, particularly without being formally trained and especially to first-year medical students who do not interact directly with patients. The present study was undertaken to assess the effectiveness of trigger films (TFs) or short movie clips as a teaching-learning tool to train undergraduate medical students on various aspects of doctor-patient relationships. Methods: Two modules on various aspects of the doctor-patient relationship were developed using TFs and written case studies and implemented on Phase Ⅰ medical students. Quantitative and qualitative feedback were collected from learners. Perception, understanding, and knowledge were assessed using pre- and post-questionnaires. The results of the feedback and questionnaires collected after using TFs were compared with those collected after using written case studies. Results: There was a gain in knowledge and understanding after TF sessions, and TF sessions were rated much higher by the students than traditional methods. Most students found TFs to be an innovative and interesting tool. The satisfaction index calculated for TFs from the feedback of both students and teachers was above 96%. Conclusions: TFs engaged the students’ affective domain, promoted reflective attitudes, and linked their learning to experiences. It was reported not only to be interesting and engaging but also effective as a teaching tool.

SLE patient satisfaction with care in Jordan: A single-center study.

Systemic Lupus Erythematosus (SLE) is a chronic multi-systemic autoimmune disease that mainly affects young females. SLE's chronicity and high level of complications yield frequent clinic visitations & hospital admissions, increasing the necessity to investigate the healthcare system and improve patient satisfaction and quality of life. This study aimed to understand SLE patients' points of view on the healthcare system in Jordan, especially given the chronic nature of the disease. With a clearer understanding, improvements can be made to benefit both the patients and the healthcare system. A cross-sectional study of 79 patients following up at the University of Jordan Hospital, rheumatology clinics were interviewed over the phone. The majority of patients were satisfied overall with the treatment services and medications as rated on a Likert scale of 1-5 (4.28 ± 1.01 and 4.19 ± 0.96, respectively) despite a quarter of patients complaining of adverse effects from the medications. The use of oral corticosteroids was significantly associated with a lower General Satisfaction Rate (p = 0.050), while high income (1000 Jordanian Dinars and above) and fatigue contributed to a lower Medication Satisfaction Rate (p = 0.016 and 0.000, respectively). A good physician-patient relationship was the most commonly cited reason for general satisfaction (73.4%) and was positively associated with the general (p = 0.000) and medication satisfaction (p = 0.004) rates. SLE patients perceived high satisfaction rates despite adverse effects and symptoms. These higher satisfaction rates were seen predominantly due to good physician-patient relationships.

A study of the correlation between residents’ humanistic care skills and their level of emotional intelligence—A cross-sectional survey

BackgroundThere is variability in the structure of junior doctors’ knowledge of humanistic medicine. The level of residents’ emotional intelligence affects their professional development and the doctor-patient relationship. Currently, there is a paucity of research examining the humanistic competence and emotional intelligence of medical residents, both domestically and internationally.The primary objective of this study was to scrutinize the prevailing status of residents’ humanistic competence and emotional intelligence levels, aiming to assess the correlation between humanistic competence and emotional intelligence.MethodsA cross-sectional survey using the Demographic Characteristics Questionnaire, the Humanistic Care Competence Scale, and the Emotional Intelligence Scale was conducted in September 2022 among residents of a tertiary general hospital in Sichuan Province. The relationship between humanistic care competence scores and emotional intelligence scores among residents was analyzed using Pearson correlation analysis and multiple linear regression analysis.ResultsThe mean score of residents’ humanistic care competence was 188.82 ± 20.80, and the mean score of emotional intelligence was 87.08 ± 13.49.The Pearson correlation results demonstrated a significant correlation (r = 0.400, p = 0.000) between the level of emotional intelligence and humanistic care competence. The results of multiple linear regression analysis indicated that self-emotional appraisal, emotional appraisal of others, emotional control, emotional use, and school community work experience independently predicted humanistic care competence.ConclusionThe scores for residents’ humanistic care competence were notably low, influenced by a multitude of factors that also exhibited varying levels of impact on emotional intelligence development. Emotional intelligence was positively associated with humanistic care competence. Emotional intelligence is an important consideration in the development, implementation, and evaluation of humanistic care interventions. Residency programs should provide education and training in humanistic competencies to improve residents’ levels of emotional intelligence and promote the overall health of society.

Communicating with Deaf Patients in the Clinical Environment: Lessons Learned from a Virtual Patient Panel

Background Communication and cultural differences predispose Deaf patients to suboptimal healthcare. Despite this disparity, health professionals have historically received little to no training in caring for Deaf patients. Patient panels are an effective tool in medical education to model communication strategies. Objective In this paper, we describe the design, implementation, and results of a virtual patient panel focused on communicating with Deaf patients in clinical contexts. We offer practical suggestions for incorporating similar educational interventions in health professions education to prepare trainees to effectively navigate these conversations with their patients. Methods The panel consisted of a one-hour question and answer discussion facilitated by the authors with Deaf patients and Certified Deaf Interpreters (CDI). The panel was presented to 271 second-year medical students at our institution in November of 2023. Following this discussion, students were encouraged to share one or two key takeaways from the session through a survey link. These results were analyzed using pile-sorting qualitative analysis to identify main themes. Results There were 73 respondents, with a response rate of 27%. After the panel, the most popular takeaway points from student reflections included communication (n=56, 77%) and access to care (n=47, 64%), followed by autonomy (n=17, 23%), the doctor-patient relationship (n=15, 21%), and culture (n=11, 15%). Based on this initiative, we identified and offer twelve tips for developing similar exercises. These tips are thematically presented under three groupings: Planning Considerations, Patient Panelist Considerations, In-Session Considerations, and Post-Session Considerations. Conclusion This patient panel was the first of its kind in our medical school curriculum. Important considerations in panel design and implementation should focus on delivery time constraints with live-interpreting and further exploring the role of trust and communication in the physician-patient relationship.

Physician-reported barriers and facilitators to thyroid hormone deprescribing in older adults.

Thyroid hormone is one of the most commonly prescribed medications in the United States. Misuse of and overtreatment with thyroid hormone is common in older adults and can lead to cardiovascular and skeletal adverse events. Even though deprescribing can reduce inappropriate care, no studies have yet explored specific barriers and facilitators to guide thyroid hormone deprescribing in older adults (defined as discontinuation of thyroid hormone when initiated without an appropriate indication or dose reduction in those overtreated). We conducted semi-structured interviews with 19 endocrinologists, geriatricians, and primary care physicians who prescribe thyroid hormone. Interviews were completed between July 2020 and December 2021 via two-way video conferencing. We used both an inductive and deductive content analysis guided by the Theoretical Domains Framework to evaluate transcribed and coded participant responses. Thematic analysis characterized themes related to barriers and facilitators to thyroid hormone deprescribing practices in older adults. The most commonly reported barriers to thyroid hormone deprescribing were related to patient-level factors, followed by physician- and system-level factors. Patient factors included patients' perceived need for thyroid hormone use and patient anxiety/concerns about potential side effects related to thyroid hormone dose reduction, patient lack of knowledge, and misinformation regarding deprescribing. Physician- and system-level barriers included clinic visit time constraints, physician inertia, physician lack of knowledge about deprescribing, perceived lack of sufficient patient follow-up, and electronic health record limitations. The most prominent physician-reported facilitators to thyroid hormone deprescribing were effective physician-to-patient communication, and positive physician-patient relationship, including patients' trust in their treating physician. Barriers and facilitators to thyroid hormone deprescribing in older adults were reported at multiple levels including patient-, physician-, and system-level factors. Interventions to improve thyroid hormone deprescribing in older adults should aim to improve patient education and expectations, increase multidisciplinary physician awareness, and overcome physician inertia.

Frida Kahlo's 70th death anniversary: a reflection on congenital anomalies and chronicities and on the role of the physician-friend.

This contribution explores the many pathologies that plague the existence of the renowned Mexican artist Frida Kahlo (1907-1954) and the impact they had on her character. Moving from a mere pathobiographical reassessment, this note, through historico-medical research, highlights the patient-physician relationship that the painter developed with Dr. Leo Eloesser (1881-1976) and underlines the role this form of friendship may play in patients' wellbeing. The special friendship between the artist/patient, Frida Kahlo, and her physician, Dr. Eloesser, shows that medicine is not just the sum of diagnoses and therapies but a much more dynamic and complex process involving trust and humane qualities.