Problematic resident-patient relationships: the patient' s perspective

Area of Science:

• Medical Education
• Primary Care
• Patient-Physician Relationship

Background:

• The doctor-patient relationship is crucial in primary care.
• Understanding patient perceptions of this relationship, especially with resident physicians, is vital for improving care quality.

Purpose of the Study:

• To identify characteristics of problematic doctor-patient relationships from the patient's perspective.
• To determine if patient demographics, clinical factors, or social attributes influence their perception of the relationship with resident physicians.

Main Methods:

• A cross-sectional survey was conducted in an adult primary care practice at an academic medical center.
• 151 patients of senior internal medicine residents completed questionnaires on their doctor-patient relationship, general health, and social support.
• Patients were categorized based on physician assessment of relationship satisfaction (problematic vs. satisfying).

Main Results:

• Patients perceiving the relationship as problematic were more likely to report low social support (76% vs. 16%).
• Residents in problematic relationships were more often described as less accessible and less capable of handling medical complaints.
• A significant portion of patients (23%) viewed relationships as problematic even when residents perceived them as satisfying.

Conclusions:

• Patient perception of a problematic doctor-patient relationship is associated with perceived resident inaccessibility and lower capability.
• Low self-perceived social support is a key factor linked to negative patient perceptions of the doctor-patient relationship.
• These findings highlight the importance of physician communication skills and patient social context in shaping relationship quality.