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J R Soc Med 2003;96:314
doi:10.1258/jrsm.96.6.314
© 2003 Royal Society of Medicine

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J R Soc Med 2003;96:314
© 2003 The Royal Society of Medicine

What's important in the doctor–patient relationship?

Angela Kubacki

Imperial College London Medical School, Department of Psychological Medicine, St Mary's Campus, Paterson Centre, 20 South Wharf Road, London W2 1PD, UK

E-mail: a.kubacki{at}imperial.ac.uk

While most of the published research into the doctor-patient relationship focuses on communication skills and behaviours, the paper by Dr Lings and colleagues (April 2003 JRSM1) provides further insight into the non-behavioural aspects of these relationships. Their findings point to ‘liking’ as a key factor of the doctor-patient relationship. This concept, however (or ‘interpersonal attraction’ as it is sometimes called), is not new to the realms of psychological research on the doctor-patient relationship. Like and Zyzanski2 found positive associations between how much the physician liked the patient and both the doctor's and the patient's satisfaction with the visit. Hall et al. 3 expanded the investigation of doctors' liking of patients and again reported a positive association between physician liking and patient satisfaction as well as finding that physicians report higher liking of patients who were male and in good health. This might lead to the notion that liking and satisfaction are synonymous, however Hall et al. 4 now suggest that liking is not simply redundant with satisfaction and is indeed an important psychological characteristic of the doctor-patient relationship. They also reported a reciprocity in terms of liking, whereby how much each liked the other was related to how much each was liked.

Given the evidence that liking and satisfaction may be single entities, 4 where does that leave rapport? If liking is being defined as ‘having an easy and comfortable relationship with the doctor’1 and it includes ‘warmth, respect, interest and enthusiasm for seeing the patient’, 2 how is this different from the concept of rapport? Is liking merely redundant of rapport or is liking at the crux of establishing a good rapport between doctors and patients? Determining the relation between liking and rapport may be another step in the process of clarifying the non-behavioural aspects important in doctor-patient communication.

REFERENCES

  1. Lings P, Evans P, Seamark D, Seamark C, Sweeney K, Dixon M, Gray DP. The doctor-patient relationship in US primary care. J R Soc Med 2003;96:180 -4[Abstract/Free Full Text]

  2. Like R, Zyzanski S. Patient satisfaction with the clinical encounter: social psychological determinants. Soc Sci Med 1987;24(4)351 -7

  3. Hall J, Epstein A, DeCiantis ML, McNeil B. Physicians' liking for their patients: more evidence for the role of affect in medical care. Health Psychol1993; 12:140 -6[CrossRef][Medline]

  4. Hall J, Horgan TG, Stein T, Roter DL. Liking in the physician-patient relationship. Patient Educ Couns2002; 48:69 -77[CrossRef][Medline]


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This Article
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