Patient satisfaction with the care they receive is influenced by the characteristics of the people treated and the physicians, by the interpersonal aspect of the therapeutic relationship, and by the health care system and related policies. says a new literature review by the Canadian Medical Protective Association.
Not surprisingly, it is the nature of the therapeutic relationship itself that has the greatest impact on the relational problems that can emerge between the patient and the doctor, say the authors, whose analysis brings together the conclusions of 92 studies carried out on this subject.
“Of all the factors demonstrated in this article, the interpersonal relationship between doctors and patients is the most important predictor of filing a complaint against a doctor,” the authors write.
Even more specifically, it is the concern and empathy perceived on the part of the doctor as well as his communication skills that influence patient satisfaction and, ultimately, the risk of a complaint being filed.
“It seems quite simple, but if we really want to improve this therapeutic relationship, it takes attention, it takes expertise, it is not as easy as it may seem,” recalled the president of the CMPA, Dr. Lisa Calder.
Empathy is especially important when breaking bad news. If the patient perceives a lack of concern and empathy on the part of their doctor, “we have just sowed the seed of a medico-legal complaint,” warn the authors.
On the patient side, the authors say, the literature suggests that ethnicity, race, culture, place of residence, literacy level, education, health status, education level, psychological disorders and the professional situation of patients can have an influence on the filing of a complaint.
Regarding the system, the authors identify the delay before obtaining an appointment with the attending physician; too short an appointment with the doctor; and difficulty in obtaining an appointment as factors that could lead to a complaint.
And even if young doctors are made aware of the importance of empathy, the reality on the ground can be very different, stressed Dr. Calder.
“We are completely overwhelmed by the pressure of the system,” she said. For example, there is pressure to see patients quickly because there is a lot of waiting, so it becomes more and more difficult to take the time we want, and unfortunately, sometimes we start to lose time. empathy. »
And that’s not to mention that medical examinations, care and treatments are increasingly complex, added Dr. Calder. Doctors generally want to give their patients as much time as they need to help them understand, “but the pressures coming from everywhere make it very difficult, the balance is very difficult to achieve,” he said. she continued.
“It may feel like empathy is going to take too long, but it only takes a few seconds and it can make a big difference,” Dr. Calder said. We should never not have time for empathy, and (this study) is a good reminder for doctors. »
Physicians should never stop learning how to communicate more effectively with their patients, she added, especially since communication issues are the ones most often brought to the CMPA’s attention.
Beyond the courses offered during their training, doctors should constantly be on the lookout for workshops, webinars, blogs and other tools that could help them become better communicators, according to her.
“Doctors can learn to communicate better without it taking more time,” she said.
The study also suggests avenues for reflection for doctors who wish to increase their vigilance with regard to potential sources of relational problems with the people who consult them.
“Recognizing these problems can contribute to improving their therapeutic relationships, reducing their medico-legal risks and improving the quality of their clinical practice,” write the authors.
The findings of this study were published by the Journal of Health Care Risk Management.