Establishing the doctor-patient relationship: science, art, or competence?

Establishing and sustaining strong doctor-patient relationships is an important aim in clinical practice, since it is through these relationships that the effectiveness of our work as healers is mediated. In recent years, a research literature emerging from the application of social science to medicine is beginning to highlight certain specific physician behaviors, especially those involved in doctor-patient communication, as actions of considerable importance to both physicians and patients. Successful physicians will further understand that our patients and their families also have high expectations for additional behaviors of physicians, particularly those recognized in the popular culture as professional, respectful of patients' circumstances, and supportive of patients' efforts. To the extent that physicians make an explicit effort to understand and appreciate the "life-world" of patients, and even to modify medical recommendations in order to maximize the meaningfulness and goodness-of-fit of these recommendations, the "art" of medicine also becomes an essential part of routine clinical practice. In the final analysis, new science, art, and behavioral competence are all required for strengthening doctor-patient relationships.