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Updated: Jun 9, 2026
14:32
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Challenges in primary care relationships: seeing it from both sides.
Neda Ratanawongsa1, Scott M Wright, Edith M Vargo
1Division of General Internal Medicine, San Francisco General Hospital, Center for Vulnerable Populations, University of California, San Francisco 94110, USA. ratanawongsan@medsfgh.ucsf.edu
Patient Education and Counseling
|September 11, 2010
Summary
Patients perceive challenging primary care relationships more positively than providers do. Both parties strive for mutual trust, despite emotional barriers, highlighting the importance of understanding patient perspectives.
Area of Science:
- Primary Care Medicine
- Qualitative Research
- Patient-Provider Relationships
Background:
- Challenging patient-provider relationships can impact healthcare delivery.
- Understanding differing perspectives is crucial for effective clinical practice.
Purpose of the Study:
- To explore the perspectives of primary care providers and patients in challenging relationships.
- To identify themes related to relationship quality, emotional barriers, and trust.
Main Methods:
- Qualitative study using semi-structured interviews with 17 provider-patient dyads.
- Providers identified patients with whom they had "challenging relationships."
- Transcripts were analyzed using an editing analysis style to identify themes.
Main Results:
- Patients rated relationship quality significantly higher (median 9) than providers (median 5).
- Key themes included differing relationship perceptions, guarding emotions, and the importance of trust.
- Participants averaged 4.6 years in their challenging relationships.
Conclusions:
- Patients generally view challenging relationships more positively than providers perceive.
- Mutual trust is a shared goal, though emotional barriers exist.
- Providers should explore patient views to foster reassurance and trust.
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