Perception of Physician-Patient Relationship Among Medical Students of a Teaching Tertiary- Care Hospital of New Delhi
Abstract
Introduction: A good physician-patient relationship is an ideal tool that helps not only formulate the diagnosis but also improve adherence and compliance of the patient towards the prescribed treatment and lifestyle adjustments. Objective: To find the level of good perception of the physician-patient relationship among medical students and various factors affecting it. Methodology: This study was conducted among postgraduate and undergraduate medical students of a tertiary-care hospital. The Patient- Practitioner Orientation Scale (PPOS), a pre-validated tool, was used in an online form to assess the physician-patient relationship and the factors affecting it. Results: A total of 579 students participated in the study. Most of the participants were below 20 years of age. 83.6% were undergraduate medical students, and most belonged to upper and upper-middle socio-economic strata. 28% reported having a first-degree relative practising medicine. Most participants felt a need for formal training in communication skills. The mean scores on the PPOS obtained by participants were low (mean score = 3.48, SD = 0.5). Scores were similar but marginally better in the caring domain. Older participants had better scores in the caring domain. Overall, females scored better in both domains, whereas the experience of physical/ verbal abuse was a significant factor for higher caring scores. Conclusion: This study found that the physician-patient relationship is poor in a tertiary hospital in Delhi. Females had better patient-doctor orientation, while most of the participants felt there was a need for formal training in improving this, in the form of a communications workshop. How to cite this arti cle:Reddy Y S K, Gedam P, Ahmad A, Ghai G, Reddy
Y S, Gupta T, Aggarwal S, Bansal T. Percepti on of
Physician-Pati ent Relati onship Among Medical
Students of a Teaching Terti ary-Care Hospital
of New Delhi. Int J Preven Curat Comm Med.
2023;9(3&4):8-15. DOI: htt ps://doi.org/10.24321/2454.325X.202307
References
Latimer T, Roscamp J, Papanikitas A. Patient- centredness and consumerism in healthcare: an ideological mess. J R Soc Med [Internet]. 2017 [cited 2022 Nov 2];110(11):425-7. Available from: https:// pubmed.ncbi.nlm.nih.gov/28949269/ [PubMed] [Google Scholar]
Sharma S. The deteriorating patient-physician relationship in India: is it time to look within? Indian J
Med Ethics [Internet]. 2019 [cited 2022 Nov 2];4 (NS) 4):330-2. Available from: https://pubmed.ncbi.nlm.
nih.gov/31540889/ [PubMed] [Google Scholar]
Tripathi J, Rastogi S, Jadon A. Changing doctor-patient relationship in India: a big concern. Int J Community
Med Public Health [Internet]. 2019 [cited 2022 Nov 2];6(7):3160. Available from: https://www.
ijcmph.com/index.php/ijcmph/article/view/4684 [Google Scholar]
Al Ali AA, Elzubair AG. Establishing rapport: physicians’ practice and attendees’ satisfaction at a Primary Health
Care Center, Dammam, Saudi Arabia, 2013. J Family Community Med [Internet]. 2016 [cited 2022 Nov 2];23(1):12-7. Available from: https://pubmed.ncbi.nlm.nih.gov/26929724/ [PubMed] [Google Scholar]
Lipworth W, Little M, Markham P, Gordon J, Kerridge I. Doctors on status and respect: a qualitative study. J Bioeth Inq [Internet]. 2013 [cited 2022 Nov2];10(2):205-17. Available from: https://pubmed.ncbi. nlm.nih.gov/23515959/ [PubMed] [Google Scholar]
Dang BN, Westbrook RA, Njue SM, Giordano TP. Building trust and rapport early in the new doctor-
patient relationship: a longitudinal qualitative study. BMC Med Educ [Internet]. 2017 [cited 2022 Nov
;17(1):32. Available from: http://dx.doi.org/10.1186/ s12909-017-0868-5 [PubMed] [Google Scholar]
Ridd M, Shaw A, Lewis G, Salisbury C. The patient-doctor relationship: a synthesis of the qualitative literature
on patients’ perspectives. Br J Gen Pract [Internet]. 2009 [cited 2022 Nov 2];59(561):e116-33. Available
from: https://pubmed.ncbi.nlm.nih.gov/19341547/ [PubMed] [Google Scholar]
Kaur A, Ahamed F, Sengupta P, Majhi J, Ghosh T. Pattern of workplace violence against doctors practicing modern medicine and the subsequent impact on patient care, in India. PLoS One [Internet].
[cited 2022 Nov 2];15(9):e0239193. Available from: https://pubmed.ncbi.nlm.nih.gov/32946495/
[PubMed] [Google Scholar]
World Health Organization [Internet]. Medical doctors (per 10 000 population); [cited 20243 AprJun 29].
Available from: https://www.who.int/data/gho/data/ indicators/indicator-details/GHO/medical-doctors-
(per-10-000-population)Medical doctors (per 10 000 population) (who.int).
Global Health Expenditure Database [Internet]. Indicators and data; [cited 2022 Nov 2]. Available
from: https://apps.who.int/nha/database/Select/Indicators/en.
Guadagnolo BA, Cina K, Helbig P, Molloy K, Reiner M, Cook EF, Peteriet DG. Medical mistrust and
less satisfaction with health care among Native Americans presenting for cancer treatment. J Health Care Poor Underserved [Internet]. 2009 [cited 2022 Nov 2];20(1):210-26. Available from: http://dx.doi. org/10.1353/hpu.0.0108 [PubMed] [Google Scholar]
Kumar M, Verma M, Das T, Pardeshi G, Kishore J, Padmanandan A. A study of workplace violence
experienced by doctors and associated risk factors in a tertiary care hospital of South Delhi, India. J Clin Diagn
Res. 2016 Nov;10(11):LC06-10. [PubMed] [Google Scholar]
Ghosh K. Violence against doctors: a wake-up call. Indian J Med Res [Internet]. 2018 [cited 2022 Nov
;148(2):130-3. Available from: http://dx.doi.org/10.4103/ijmr.IJMR_1299_17 [PubMed] [Google Scholar]
Peng W, Ding G, Tang Q, Xu L. Continuing violence against medical personnel in China: a flagrant violation
of Chinese law. Biosci Trends [Internet]. 2016 [cited 2022 Nov 2];10(3):240-3. Available from: https://
pubmed.ncbi.nlm.nih.gov/27245351/ [PubMed] [Google Scholar]
Hobbs FD, Keane UM. Aggression against doctors: a review. J R Soc Med [Internet]. 1996 [cited 2022 Nov
;89(2):69-72. Available from: https://pubmed.ncbi. nlm.nih.gov/8683503/ [PubMed] [Google Scholar]
Working Party of the Royal College of Physicians. Doctors in society. Medical professionalism in a
changing world. Clin Med (Lond) [Internet]. 2005 [cited 2022 Nov 2];5(6 Suppl 1):S5-40. Available from: https://pubmed.ncbi.nlm.nih.gov/16408403/ [PubMed] [Google Scholar]
Yaffe MJ. The medi-drama as an instrument to teach doctor-patient relationships. Med Teach [Internet].
[cited 2022 Nov 2];11(3-4):321-9. Available from: https://pubmed.ncbi.nlm.nih.gov/2640693/ [PubMed]
[Google Scholar] 18. Krupat E, Yeager CM, Putnam S. Patient role orientations, doctor-patient fit, and visit satisfaction. Psychol Health. 2000 Sep;15(5):707-19. [Google Scholar]
Kishore J, Kohli C, Kumar N, Gupta N. Scales used in India to evaluate socio-economic status in medical
research: limitations of existing scales and the need of a more comprehensive one. J Int Med Sci Acad. 2017;27(1):69-77. [Google Scholar]
Balentine CJ, Ayanbule F, Haidet P, Rogers J, Thompson B, Chang T, Horwitz I, Tseng E, Berger DH. The patient- physician relationship in surgical students. Am J Surg [Internet]. 2010 [cited 2022 Nov 2];200(5):624-7.
Available from: https://pennstate.pure.elsevier. com/en/publications/the-patientphysician- relationship- in-surgical-student [PubMed] [Google Scholar]
Wahlqvist M, Gunnarsson RK, Dahlgren G, Nordgren S. Patient-centered attitudes among medical students:
gender and work experience in health care make a difference. Med Teach [Internet]. 2010 [cited 2022 Nov
;32(4):e191-8. Available from: https://pubmed.ncbi. nlm.nih.gov/20353319/ [PubMed] [Google Scholar]
Ribeiro MM, Krupat E, Amaral CFS. Brazilian medical students’ attitudes towards patient-centered care. Med
Teach [Internet]. 2007 [cited 2022 Nov 2];29(6):e204-
Available from: https://pubmed.ncbi.nlm.nih. gov/17922360/ [PubMed] [Google Scholar]
Hammerich K, Stuber K, Hogg-Johnson S, Abbas A, Harris M, Lauridsen HH, Lemeunier N, Maiers M, McCarthy
P, Morales V, Myburgh C, Petrini V, Pohlman K, Mior S. Assessing attitudes of patient-centered care among
students in international chiropractic educational programs: a cross-sectional survey. Chiropr Man Therap
[Internet]. 2019 [cited 2022 Nov 2];27(1):46. Available from: https://pubmed.ncbi.nlm.nih.gov/31528334/
[PubMed] [Google Scholar]
Liu W, Hao Y, Zhao X, Peng T, Song W, Xue Y, Tao S, Kang Z, Ning N, Gao L, Cui Y, Liang L, Wu Q. Gender
differences on medical students’ attitudes toward patient-centered care: a cross-sectional survey
conducted in Heilongjiang, China. Peer J [Internet]. 2019 [cited 2022 Nov 2];7(e7896):e7896. Available
from: https://pubmed.ncbi.nlm.nih.gov/31660273/ [PubMed] [Google Scholar]
Hur Y, Cho AR, Choi CJ. Medical students’ and patients’ perceptions of patient-centered attitude. Korean J Med
Educ [Internet]. 2017 [cited 2022 Nov 2];29(1):33-9. Available from: https://pubmed.ncbi.nlm.nih.
gov/28264552/ [Google Scholar]
Beattie A, Durham J, Harvey J, Steele J, McHanwell S. Does empathy change in first-year dental students?
Eur J Dent Educ [Internet]. 2012 [cited 2022 Nov 2];16(1):e111-6. Available from: https://pubmed.ncbi. nlm.nih.gov/22251333/ [PubMed] [Google Scholar]
Hurley EA, Doumbia S, Kennedy CE, Winch PJ, Roter DL, Murray SM, Harvey SM. Patient-centered attitudes
among medical students in Mali, West Africa: a cross- sectional study. BMJ Open. 2018 Jan;8(1):e019224.
[PubMed] [Google Scholar]
Moore M. What do Nepalese medical students and doctors think about patient-centered communication?
Patient Educ Couns. 2009 Jul;76(1):38-43. [PubMed] [Google Scholar]
Ahmad W, Krupat E, Asma Y, Fatima NE, Attique R, Mahmood U, Waqas A. Attitudes of medical students
in Lahore, Pakistan towards the doctor–patient relationship. Peer J. 2015 Jun 30;3:e1050. [PubMed]
[Google Scholar]
Madhan B, Rajpurohit AS, Gayathri H. Attitudes of postgraduate orthodontic students in India towards
patient-centered care. J Dent Educ [Internet]. 2011 [cited 2022 Nov 2];75(1):107-14. Available from:
https://pubmed.ncbi.nlm.nih.gov/21205735/ [PubMed] [Google Scholar]
Anand T, Grover S, Kumar R, Kumar M, Ingle GK. Workplace violence against resident doctors in
a tertiary care hospital in Delhi. Natl Med J India. 2016;29:344-8. [PubMed] [Google Scholar]
Rosewilliam S, Indramohan V, Breakwell R, Liew BXW, Skelton J. Patient-centered orientation of students from
different healthcare disciplines, their understanding of the concept and factors influencing their development
as patient-centered professionals: a mixed methods study. BMC Med Educ [Internet]. 2019 [cited 2022 Nov
;19(1):347. Available from: http://dx.doi.org/10.1186/ s12909-019-1787-4 [PubMed] [Google Scholar]
Makoul G, Arntson P, Schofield T. Health promotion in primary care: physician-patient communication and
decision making about prescription medications. Soc Sci Med [Internet]. 1995 [cited 2022 Nov 2];41(9):1241-
Available from: https://www.sciencedirect.com/ science/article/pii/027795369500061B [PubMed]
[Google Scholar]
Sethi S, Pardeshi G, Kishore J. Communication skills for interns: evolution and assessment of a training workshop in a medical college of New Delhi. Int J Healthc Edu Med
Inform. 2019;6(2):17-22. [Google Scholar]
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