School of Medicine, Buenos Aires University, Buenos Aires, Argentina.
Medical Education Research Laboratory, Hospital Alemán, Buenos Aires, Argentina.
Rev Med Chil. 2020 Jul;148(7):930-938. doi: 10.4067/S0034-98872020000700930.
From a patient's point of view, an 'ideal' doctor could be defined as one having personal qualities for interpersonal relationships, technical skills and good intentions. However, doctors' opinions about what it means to be a 'good' patient have not been systematically investigated.
To explore how patients define the characteristics of a 'good' and a 'bad' doctor, and how doctors define a 'good' and a 'bad' patient.
We surveyed a cohort of 107 consecutive patients attending a community teaching hospital in February 2019, who were asked to define the desirable characteristics of a good/bad doctor. Additionally, a cohort of 115 physicians working at the same hospital was asked to define the desirable characteristics of a good/bad patient. Responses were subjected to content analysis. Simultaneously, an algorithm in Python was used to automatically categorize responses throughout text-mining.
The predominant patients' perspective alluded to desirable personal qualities more importantly than proficiency in knowledge and technical skills. Doctors would be satisfied if patients manifested positive personality characteristics, were prone to avoid decisional and personal conflicts, had a high adherence to treatment, and trusted the doctor. The text-mining algorithm was accurate to classify individuals' opinions.
Ideally, fusing the skills of the scientist to the reflective capabilities of the medical humanist will fulfill the archetype of what patients consider to be a 'good' doctor. Doctors' preferences reveal a "paternalistic" style, and his/her opinions should be managed carefully to avoid stigmatizing certain patients' behaviors.
从患者的角度来看，“理想”的医生可以被定义为具有人际交往个人品质、技术技能和良好意愿的医生。然而，医生对成为“好”患者意味着什么的看法尚未得到系统的研究。
探讨患者如何定义“好”医生和“坏”医生的特征，以及医生如何定义“好”患者和“坏”患者。
我们调查了 2019 年 2 月在一家社区教学医院就诊的 107 名连续患者队列，他们被要求定义理想的好/坏医生的特征。此外，还要求在同一家医院工作的 115 名医生定义理想的好/坏患者的特征。对回答进行了内容分析。同时，使用 Python 中的算法通过文本挖掘自动对回答进行分类。
患者观点主要强调个人品质，而不是知识和技术技能的熟练程度。如果患者表现出积极的个性特征、避免决策和个人冲突、高度遵守治疗方案并信任医生，医生就会感到满意。文本挖掘算法能够准确地对个人意见进行分类。
理想情况下，将科学家的技能与医学人文主义者的反思能力融合起来，将满足患者认为的“好”医生的典范。医生的偏好反映出一种“家长式”的风格，应该谨慎管理他们的意见，以避免污名化某些患者的行为。
