Max Stern Yezreel Valley College, Afula, Israel.
Sheffield Hallam Business School, Sheffield University Management School, Conduit Road, Sheffield, S10 3FL, UK.
Isr J Health Policy Res. 2020 Jun 30;9(1):33. doi: 10.1186/s13584-020-00375-4.
The issue of patient-physician relationships in general, and particularly the trust of patients in their primary care physician has gained much interest in academia and with practitioners in recent years. Most research on this important topic, however, focused on how patients view the relationship and not how the physicians see it. This research strives to bridge this gap, with the resolution of leading to an improved appreciation of this multifaceted relationship.
A survey of 328 actively practicing physicians from all four health maintenance organizations (HMOs) in Israel resulted in a hierarchical formation of components, indicating both the relative as well as absolute importance of each component in the formation of the patient-physician relationship. The sample conducted was a convenience one. Methodologically, we used two different complementary methods of analysis, with the primary emphasis on the Analytic Hierarchical Processing (AHP), a unique and advanced statistical method.
The results provide a detailed picture of physicians' attitudes toward the patient-physician relationship. Research indicates that physicians tend to consider the relationship with the patient in a rather pragmatic manner. To date, this attitude was mostly referred to intuitively, without the required rigorous investigation provided by this paper. Specifically, the results indicate that physicians tend to consider the relationship with the patient in a rather pragmatic manner. Namely, while fairness, reliability, devotion, and serviceability received high scores from physicians, social interaction, friendship, familial, as well as appreciation received the lowest scores, indicating low priority for warmth and sociability in the trust relationship from the physician's perspective. The results showed good consistency between the AHP results and the ANOVA comparable analyses.
In contrast to patients who traditionally stress the importance of interpersonal skills, physicians stress the significance of the technical expertise and knowledge of health providers, emphasizing the role of competence and performance. Physicians evaluate the relationship on the basis of their ability to solve problems through devotion, serviceability, reliability, and trustworthiness and disregard the "softer" interpersonal aspects such as caring, appreciation, and empathy that have been found to be important to their patients. This illustrates a mismatch in the important components of relationship building that can lead to a loss of trust, satisfaction, and repeat purchase.
We study the impact physicians' incentives have on the tangible relationship and discuss the significance of physician-patient relationship on satisfaction with the health service given. As a result policies leading to a more dynamic role must be given to the patient, who being well informed by the physician, can help in the decision making process. Policy schemes need to be implemented as a way of changing physicians' behavior, forcing them to better construct and utilize this dyadic relationship.
近年来，医患关系，尤其是患者对初级保健医生的信任问题，引起了学术界和从业者的极大兴趣。然而，大多数关于这一重要主题的研究都集中在患者如何看待这种关系上，而不是医生如何看待这种关系。本研究旨在弥合这一差距，其目的是更好地理解这种多方面的关系。
对来自以色列 4 家健康维护组织（HMO）的 328 名在职医生进行了调查，结果形成了一个层次结构的组成部分，表明每个组成部分在医患关系形成中的相对重要性和绝对重要性。所进行的抽样是一种方便的抽样。在方法上，我们使用了两种不同的互补分析方法，主要侧重于分析层次处理（AHP），这是一种独特而先进的统计方法。
研究结果提供了医生对医患关系态度的详细描述。研究表明，医生往往以相当务实的方式看待与患者的关系。到目前为止，这种态度大多是凭直觉提出的，而不是本文所要求的严格调查。具体来说，研究结果表明，医生往往以相当务实的方式看待与患者的关系。也就是说，虽然公平、可靠、投入和服务得到了医生的高分，但社会交往、友谊、亲情以及感激却得到了最低分，这表明从医生的角度来看，信任关系中对温暖和社交的重视程度较低。研究结果表明，AHP 结果与方差分析可比分析之间具有良好的一致性。
与传统上强调人际技能重要性的患者不同，医生强调卫生保健提供者的技术专长和知识的重要性，强调能力和绩效的作用。医生根据投入、服务、可靠性和可信赖性来评估关系，而不考虑对患者很重要的“更软性”的人际关系方面，如关怀、感激和同理心。这说明了关系建立的重要组成部分之间存在不匹配，可能导致信任、满意度和重复购买的丧失。
我们研究了医生激励对有形关系的影响，并讨论了医患关系对患者对所提供的医疗服务的满意度的重要性。因此，必须赋予患者更积极的角色，让患者在得到医生充分告知的情况下，帮助参与决策过程。需要实施政策计划，以改变医生的行为，迫使他们更好地构建和利用这种二元关系。
