Who Needs the Relationship More: Doctors or Patients?

Pamela L. Wible, MD

Disclosures

August 23, 2017

In This Article

Who Needs the Relationship More?

Many doctors claim the most fulfilling part of their job is the patient relationship. But do patients really want a relationship with their doctor? Many patients switch doctors whenever their insurance plan changes, and it's no big deal to them. So who really needs the relationship more? And why?

To investigate, I interviewed 122 physicians who answered the question: "Who needs the relationship more: the doctor or the patient?" It's the patient, of course, claimed 42% of the physicians. Yet 17% of the physicians asserted that the doctor is the one who truly needs the relationship; 35% believed that both doctor and patient need each other; 3% said it depends on the specialty and circumstances; and nearly 3% believed that neither the doctor nor the patient needs the relationship at all.

Arguments for Patients Being Needier

"The patient is most dependent on the doctor—they need the relationship," states internist Allan Kelly, MD. "They are so much in need that they will pay money."

For many physicians, a patient visit is merely an economic transaction—an honorable way to make a living. Whereas a patient has a greater need to relieve symptoms or treat disease, the doctor would have no job or income without the patient.

Yet a therapeutic relationship between a skilled physician and a suffering patient is unique in its scope—it is even sacred—and it may transcend the superficial financial and physical encounter to involve a deeper emotional and spiritual connection.

"I think the patient needs the relationship more," discloses family physician Steven Powell, MD. "I need the relationship for some sort of spiritual fulfillment. It is much richer than most other human-to-human interactions. I can take or leave any individual patient or group of patients. I wish them well and try to do what is right for them, and worry about some of them when I get home. But I don't have any prolonged attachment."

"Proof of this to me is that I recently left my job of 10 years at a large multispecialty group," says Dr Powell. "On receiving my farewell letter, patients came in for weeks with outpourings of sorrow, disappointment, even tears. I was simply overwhelmed. I really did not expect that attachment. I was very moved and so very grateful. But I definitely did not cry—at all. I have been ready to move on for years and don't regret it."

"As a primary care physician, I have a unique relationship with my patients," shares family physician Kevin Bluemel, MD. "I discuss things that nobody else, sometimes not even their spouses, talks to them about. I am allowed access to their deepest secrets. They willingly let me place my hands and fingers in places that they wouldn't let themselves or anyone else place them."

"But I do this with 20-plus patients every day," Dr Bluemel adds, "whereas I am the only person that they discuss these things with or let do those potentially embarrassing things to. So I have that sensitive relationship with hundreds, even thousands of patients, whereas they usually only have that relationship with one person—me. Thus, I think the answer to the question is that the patient needs the relationship more."

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