Prevention in adulthood: forging a doctor-patient partnership

In this ever-changing health care system, Americans still retain confidence in their individual physicians [11]. This confidence represents an impressive fact when placed in the context of today's threats to the physician-patient relationship. In this chapter, we have explored these threats, principle among which are the appearance of the hospitalist, the information and technology revolution and the preeminence of managed care. We have further attempted to describe particular physician characteristics that may affect the quality of the physician-patient relationship. Individual physician awareness and characteristics seem to form the cornerstone for the quality of the relationship. We certainly believe in and stress the importance of shared mutual obligations in the good physician-patient relationship. Descriptors such as patients' trust and physicians' empathy enable meaningful relationships to be nurtured over time. A key component worthy of the primary care physician's consideration is that of longitudinal, continuity of care. In a study that examined patients' trust in their physicians, nearly three fourths of those surveyed were confident that their physicians would "put (the patient's) needs above all other considerations" [12]. Despite the limitations inherent in the modern American medical environment, it is still possible for physicians to nurture trusting, effective relationships with their patients and ultimately enhance health outcomes.