The Shocking Truth about Patient Relationships in Primary Care
Relationships are a source of pleasure, whose absence will make you wonder why you chose primary care. The hope of many long lasting patient relationships is what drew me, as well as most of my colleagues into primary care. Leaving my clinical practice after 28 years of being a family doctor was more difficult than I anticipated. I was surprised by the emotion that I shared with both my female and male patients.
These feelings were not a result of how broken primary care has become, rather the personal connections that had been formed with my patients. I realized that I was leaving behind the best discipline that medicine had to offer.
Relationships create pleasure
Knowing people, being involved with people, helping people, watching people grow, develop and change, over a period of time, is probably the most exciting part of life and we get to experience each of these in primary care. This is what distinguishes primary care from specialty groups.
The Commonwealth Fund recently published an article on primary care being our first line of defense in light of today’s healthcare crisis. They acknowledged that it is not just about seeing any doctor trained in primary care, but more importantly seeing “a regular doctor you can trust.”
To trust someone is to become vulnerable and dependent on another person’s intentions and motivations. It is only developed within the context of a continuous relationship.
Trust creates pleasure for patients because their doctor knows them and understands their medical needs. On the other hand, trust creates pleasure for physicians because they know that they are meeting their patient’s needs.
Relationships encourage patient engagement
One of my patients, Dan, smoked 3 packs of cigarettes a day for 30 years. From the time I first met him, I talked with him about his smoking habit. Over the course of several years, I encouraged him to quit and warned him of the damages he was causing his body.
The day I learned about Dan finally quitting smoking, was the day our office was being interviewed by a Business Week reporter. The reporter asked Dan what made him decide to quit smoking. He immediately turned to me and answered, “He did!” “He never gave up on me, he kept talking about it and I decided that he was right.”
That’s the value of relationships; you cannot change habits and behaviors only based on evidence. It is building a relationship that has value to a patient, which then translates into motivation for the patient, and motivated patients create different outcomes for themselves and their culture.
It goes without saying that America’s healthcare is in crisis, especially primary care. However, as I was saying goodbye to my patients, whom I had built deep meaningful relationships with, I realized that there is never a bad time to be a primary care physician.