Greasing the Wheels

Abstract

The relationship between families and their physician is the most powerful vehicle for influencing patients about issues regarding health and illness. Physicians influence their patients and patients influence their physicians. The doctor—patient relationship is an essential subsystem of the biopsychosocial approach to treatment. As such, it deserves special thought and consideration, and careful assessment when this alliance is problematic. The way the physician handles his or her part in the doctor—patient relationship can affect a patient’s sense of well-being and the likelihood that a patient and family will cooperate with any given treatment plan, not to mention the physician’s own sense of job satisfaction. For these important reasons, we will now turn to some pragmatic suggestions for promoting a constructive working alliance with patients and family members. We will focus on the physician’s side of this equation because that is what we can alter. Three fundamental interviewing skills enhance the potential for an effective partnership to develop between physician and family: building rapport, structuring the interview, and converting resistance into cooperation.