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Communication key in doctor-patient relationship

I couldn't agree more that doctor-patient relationships based on trust have a positive impact on healthcare in the country (College runs range of post-grad courses for family doctors, by the College of Family Physicians Singapore; Sept 12).

It is most unfortunate that we are witnessing an erosion of that sacred connection, given that malpractice lawsuits are now a common reaction to unsatisfactory outcomes of treatment.

However, the increase in complaints may not point to a declining standard of patient care, but to miscommunication between patients and clinicians.

Despite patients being more knowledgeable and having correspondingly higher expectations, they still interact with their physicians from a position of disadvantage.

Explicit information about the clinician-patient relationship and informed consent must be repeatedly emphasised in medical schools as well as during postgraduate training.

During clinical consultations, it is standard practice for a doctor to inform his patients of the risks that they should be concerned about. It is highly unlikely that a doctor would not be aware of his patient placing specific importance to the disclosure of risks, following a detailed consultation.

Often, a patient complains about the outcome when it is far from what he anticipated. Patients must be informed of what to expect at the various treatment stages. If there are additional charges, tests or deviations from the original plan, doctors should update the patients and their families as soon as possible.

Patients who are misled into believing that surgery will provide an absolute cure may be more likely to sue if the procedure fails, compared with patients who understand the inherent limits of any treatment.

When a treatment plan is communicated satisfactorily from the outset and agreed upon by the patient, complaints may not arise in the first place. Doctors and patients both need to understand the limits of medical knowledge; judgment calls are required at times. Both parties must learn to tolerate the uncertainty from this limitation.

Doctors must be reminded during their training that good practice is the best remedy to malpractice accusations.

Edmund Khoo Kim Hock

A version of this article appeared in the print edition of The Sunday Times on October 01, 2017, with the headline 'Communication key in doctor-patient relationship'. Print Edition | Subscribe