Doctor-patient relations in dermatology: obligations and rights for a mutual satisfaction

The author examines different aspects of patient-doctor relationship in dermatological consultations. At first, a definition of patients satisfaction is given, based on available literature. It has been shown that satisfaction depends on diagnosis, but also on the doctor's ability to provide explanations on the probable cause of the illness, information on how long the symptom will probably last, and if she/he demonstrates empathy. Satisfaction also increases if the illness is serious, but decreases if quality of life linked to the symptom is underestimated by the doctor. After providing a philosophical definition of ethics, which emphasizes the importance of mutual satisfaction of patient and doctor, the concepts of empathy and compassion in patient-doctor relations are defined. Their importance in consultations is underlined, reporting, for example, that doctors with good communication skills experience fewer difficult consultations (8% vs. 23%). Afterwards, the dermatological consultation is analysed in its practical aspects, trying to define a good-quality consultation. First of all, the pitfalls that can affect good time management are analysed, suggesting to structure the consultation using the Soap method. Particular situations are analysed, such as announcing bad news and dealing with borderline patients. Finally, the concept of transference is defined, remembering that doctor-patient relationships can replay some difficult relationship coming from the past, and thus doctors need to be aware of this possibility and learn how to manage it.