It is very uplifting to find that people have a doctor to whom they have been going for years. Unfortunately, it is becoming commonplace for people to change doctors, or request not to see a certain general practitioner. As a physiotherapist, patients often tell the real reasons why they prefer some doctors over others.
Some time ago, during a consultation with a patient, she asked me if I knew of any good doctors. I was taken aback initially because I was practicing in a medical centre, with a number of wonderful doctors working at the practice.
When I asked if he had seen one of the doctors at the practice, he replied that he had seen most of them. He further told me he had recently moved to the city and was in search of a regular doctor who he could trust, like the one he had previously.
A few weeks later, another patient mentioned she was unhappy with the doctor she had just seen, and wanted to see someone else.
Incidents like these continued at various times over the course of about a year, when it finally dawned on me that this was a common problem, and that doctors should be aware of it and take action to minimalize its occurrence, if not prevent it altogether.

Some of the reasons the patients told me for not liking doctors were:

• Patients perceiving that the doctor was not actively listening to them.
Some of the common statements from patients included “I just felt like I was taking up his time”; “he did not even look at the area I complained about, he was just typing and did not look at me”.
• Lack of adequate patient education. This was a common one among patients who felt that doctors used medical jargon, that they could not understand, leaving them confused about their situation.
• Lack of reassurance. Some patients stated they did not feel at ease because the doctor didn’t seem concerned about them, for example by not offering any reassurance of a commitment to help them solve their problems.
• Misdiagnoses; This was very disconcerting to some patients who mentioned that they found out that they had a serious disease, that was only diagnosed by one doctor, after they had been to a number of doctors who continued to assure them that it was nothing serious that would subside
• Not acknowledging “their pain”
A patient told me that he had been to a doctor who said that the pain was just psychological, and told him he was lying about his pain.

What can be done?

It is apparent from the above that there is a high demand from patients to see more patient-centred doctors who take time to listen to them. Therefore, having good communication skills (both verbal and non-verbal) is critical for doctors to develop and maintain a good patient-doctor relationship.

Bakić-Mirić, & Bakić (2008) stipulated in their article that there are seven traits are essential for all clinicians and they have been included here with their definitions from patients’ perspectives.

• Confidence: “The doctor’s confidence gives me confidence”.
• Empathetic: The patients see that the doctor is trying to understand their emotions, and relays this understanding to them
• Humane: The patients want to see compassion, care and kindness
• Personal: “ I can see that the Doctor is interested in me more than just as a patient, but talks to me and remembers me as a person”
• Frank: “I am informed of what is necessary in plain and straightforward language”
• Respectful: “My input and feelings are taken seriously and the doctor collaborates with me”
• Thorough: “The doctor is conscientious and persistent”.

Furthermore, Bakić-Mirić, & Bakić (2008) cited that according to the Bayer Institute for Health Communications and the Fetzer Institute at a conference organized by the Association of American Medical Colleges in Cincinnati In May 1999, seven components were identified as key to all doctor-patient interviews. They include:

• Build the relationship
• Open the discussion
• Gather information
• Understand the patient’s perspective
• Share information
• Reach agreement on problems and plans
• Provide closure
These can be applied in any patient-doctor interaction in simple ways such as beginning with a sincere greeting, eye contact, a brief nonmedical interaction such as checking on a significant life event.
Secondly, a doctor can intently observe the patient and their own reasoning and thoughts to avoid unintentionally dominating the interaction. It is quite important that the patient be allowed to provide relevant details, while the doctor empathetically acknowledges their input, therefore encouraging the patient to reveal expectations and beliefs about their ailments and consequently avoiding a premature conclusion to the conversation (Nelson & Vega, 2008).
This would aid the formation of an effective patient-oriented treatment plan

References
Bakić-Mirić, N., & Bakić, N. (2008). Successful Doctor-Patient communication and rapport building as the key skills of medical practice. Medicine and Biology 15(2) 74 – 79.

Nelson, R., & Vega, C. (2008) Improving communication skills enhances efficiency and patient-clinician relationship, Archives of Internal Medicine 168(13) 1364.

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