The Singapore Medical Council's new guidelines for doctors will be effective in resolving the issues of poor communication ("1 in 5 complaints against docs due to poor communication"; Sept 18).
However, good communication must be a two-way process. It is also important to promote a system in which patients build a trusting relationship with their doctors, and clearly express their values and preferences. This will promote effective shared decision-making.
Patients should consider whose carethey want to receive at their moment of greatest need. Who is better equipped to meet their preferences or values: a doctor with whom they are well acquainted or one they have only just met?
The fact is that the doctor-patient relationship is built largely on trust, and levels of trust are usually lower among strangers.
Practically speaking, as the number of doctors caring for a patient increases, the depth of the doctor-patient relationship tends to diminish and, even worse, lead to miscommunication or misunderstanding.
Moreover, as patient care becomes progressively fragmented, many doctors find it more difficult to provide truly integrated care.
In this age of advancing technologies, such as electronic health records, patients might have experienced watching their physician silently entering the required information into the computer. They might have felt that the visit was rushed, impersonal and largely bureaucratic.
The real problem is that in the current environment of time-pressured primary care, it is hard to have sufficient opportunities for the in-depth, personalised conversation necessary to create and sustain a meaningful doctor-patient relationship.
Through my decades of clinical experience, I have found that the closer the doctor-patient relationship, the greater the potential that the relationship will prove valuable and fulfilling for both parties.
A good hospital is undoubtedly a great asset to patient care. However, the true core of good medicine is not an institution but a relationship between doctor and patient.
If a patient wants to receive the best possible care, the first step is to find a doctor he considers his family physician, whom he can consult for any medicine-related matter.
Strict guidelines for healthcare providers are not sufficient for truly effective doctor-patient communication. From the long-term perspective, we need to create a system in which people can develop a trusting doctor-patient relationship.
Hajime Ichiseki (Dr)