¶ … obstacles physician patient relationship. Must include quotes citation Deborah Tannen writing "Talk the Intimate Relationship" Obstacles to a good physician-patient relationship

The physician-patient relationship is one of the most intimate and important relationships in many individual's lives. For the relationship to function in an optimal fashion, patients must often share information about their lifestyle habits, personal aspirations, sexuality, and feelings about their spouses with their physicians. However, a physician's desire to maintain a professional distance can result in communication barriers that inhibit the sharing of such thoughts and feelings. Examining some of the barriers that exist between patients and physicians, using some of the ideas and concepts from relationship therapy, and the differences between men and women can be useful. For example, according to Deborah Tannen's essay "Talk: The Intimate Relationship," the reason men and women often experience barriers to intimacy and a full and free flow of dialogue is that "male-female conversation is cross-cultural communication. Culture is simply a network of habits and patterns gleaned from past experience, and women and men have different past experiences. From the time they're born, they're treated differently, talked to differently, and talk differently as a result."

This is also true of physicians and patients. Physicians are acculturated into a different viewpoint of the human body: they see the body in a scientific fashion that may seem cold and unemotional to their patients without medical training. A patient that has just been diagnosed with cancer's first immediate thoughts is: "will I survive?" From a physician's point-of-view, this question can only be answered in a qualified fashion -- it depends on the type of tumor, type of cancer, and treatment options. The physician will often use the language of science, while the patient reacts in a far more personal fashion, wondering what the impact of the disease will be upon his or her future an the future of his or her family.

But the doctor must remember that the patient does not necessarily speak the language of medicine and science, and understand the psychological barriers and difficulties absorbing serious medical information, when talking to the patient. Furthermore, acting with sensitivity and grace to the suffering of the patient will actually improve the patient's ability to retain information and to make good decisions. This is especially important when quick decision-making is required, such as in an emergency room. For example, a parent may need to authorize treatment for his or her child. The "meta-messages of talk" or the value of bonding with apparently inconsequential chatter should not be discounted in the physician-patient relationship.
Sometimes, patients can project unintended emotional meanings into a doctor's standard operating procedures. For example, when a patient receives a screening procedure such as an MRI, he or she might not understand why the results are not read immediately by the doctor. For the doctor, reading such results is simply part of the daily routine, and the patient's results are one among many things he or she has to do. The patient may not perceive that the doctor has many other patients, because of his or her emotional feelings about the test. The patient may perceive the doctor as incompetent or uncaring as a result, and be less apt to view the doctor in a positive fashion.

Doctors may also feel frustrated when the patient vents his or her displeasure about the medical system as a whole upon the physician. The patient may be angry that his or her insurance company has denied coverage of a procedure the doctor has suggested and feel confused, and take out this anger against the doctor. "Why did you recommend this to me, when you knew it wouldn't be covered?" The patient cries, even though the doctor could not have known that the insurance company would not cover the procedure. In fact, the…