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Multicenter Study
. 2009 Apr;59(561):e116-33.
doi: 10.3399/bjgp09X420248.

The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives

Matthew Ridd  1 , Alison Shaw, Glyn Lewis, Chris Salisbury
Affiliations
Multicenter Study

The patient-doctor relationship: a synthesis of the qualitative literature on patients' perspectives

Matthew Ridd et al. Br J Gen Pract. 2009 Apr.

Abstract

Background: The patient-doctor relationship is an important but poorly defined topic. In order to comprehensively assess its significance for patient care, a clearer understanding of the concept is required.

Aim: To derive a conceptual framework of the factors that define patient-doctor relationships from the perspective of patients.

Design of study: Systematic review and thematic synthesis of qualitative studies.

Method: Medline, EMBASE, PsychINFO and Web of Science databases were searched. Studies were screened for relevance and appraised for quality. The findings were synthesised using a thematic approach.

Results: From 1985 abstracts, 11 studies from four countries were included in the final synthesis. They examined the patient-doctor relationship generally (n = 3), or in terms of loyalty (n = 3), personal care (n = 2), trust (n = 2), and continuity (n = 1). Longitudinal care (seeing the same doctor) and consultation experiences (patients' encounters with the doctor) were found to be the main processes by which patient-doctor relationships are promoted. The resulting depth of patient-doctor relationship comprises four main elements: knowledge, trust, loyalty, and regard. These elements have doctor and patient aspects to them, which may be reciprocally related.

Conclusion: A framework is proposed that distinguishes between dynamic factors that develop or maintain the relationship, and characteristics that constitute an ongoing depth of relationship. Having identified the different elements involved, future research should examine for associations between longitudinal care, consultation experiences, and depth of patient-doctor relationship, and, in turn, their significance for patient care.

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Figures

Figure 1
Figure 1
Study inclusion/exclusion process.
Figure 2
Figure 2
Conceptual framework of the patient–doctor relationship.
See this image and copyright information in PMC

Comment in

  • The future for personal doctoring.
    Haggerty J. Haggerty J. Br J Gen Pract. 2009 Apr;59(561):236-7. doi: 10.3399/bjgp09X420275. Br J Gen Pract. 2009. PMID: 19341550 Free PMC article. No abstract available.

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