Patient-Physician Relationships: Getting it Right

Not every relationship was meant to be. Sometimes, that can be the case even between a patient and a physician. It doesn’t happen often, but when it does, what can be done?

“We needed a consistent process to support both patients and physicians fairly,” said Cathy Pilot, a Patient Family Advisor at Thunder Bay Regional Health Sciences Centre.

Cathy, now retired, served as an Intensive Care Unit nurse for over 19 years, and also worked as a Utilization Coordinator. She now volunteers at the Hospital, providing her perspective as a patient.

Cathy participated in meetings with the Medical Advisory Committee to develop a process to use when a patient wants a different physician than the one providing care. This can happen for a variety of reasons, including a difference of opinion in treatment. Why is a process needed? “Patients must have a valid reason. Physicians are working to do the best thing for the patient, but may not be perceived that way by the patient,” explained Cathy.

It was important to include a Patient Family Advisor in the discussions. “I listened to what the physicians had to say, and how this affected them. Physicians didn’t have a standard recourse for these situations, and were also concerned because the number of physicians available to provide care is limited,” Cathy says. “From the patient point of view, we want to feel comfortable, and understand our rights. Everyone has to work together for the best outcome.”

That outlook guided discussions, and resulted in a new tool to guide patients and physicians to make the best decisions when there is a relationship concern. “Before changes are made, it’s important to see if the relationship can be repaired. Our process begins there,” explained Cathy.

If a patient is not satisfied, the opinion of a second physician may be offered. If there is still a concern, it will be brought to the Nurse Manager or the Department Chief, depending on the situation. The Hospital’s Patient Advocate will work with the Department Chief to review the concern.

It’s the role of the Patient Advocate to work with the Department Chief for the best outcome for the patient. This may mean a new physician is assigned to the patient, or that the patient receives an explanation as to why they will continue to be cared for by the same physician.

“This process respects both the physicians and their roles, as well as the concerns of the patients,” noted Cathy. “It really provides clarity when there is disagreement, and supports everyone involved to fully understand the issue so the best solution can be identified.”