Doctor-Patient Relationships: A Puzzle of Fragmented Knowledge

Abstract

The doctor-patient relationship has been and remains a keystone of care. But, there are many ways of understanding, classifying and practicing the doctor-patient relationship. In this scenario, this article begins the task of organizing the different ways of understanding, naming, differentiating, classifying and practicing the doctor-patient relationship. It is concluded that the following concepts can be differentiated: 1) Hierarchy of complexity dimensions of the doctor-patient continuity relationship; 2) According to historical stages; 3) According to the degree of interpersonal relationship; 4) According to the control exercised by the physician or the patient; 5) According to the level of participation; 6) According to the “creators of contexts” models); 7) According to the length of interpersonal continuity; 8) According to pharmacological prescriptions; 9) According to the characteristics of medical service; 10) According to the psychosocial aspects of diseases; 11) According to age; and 12) Doctor-patient relationship with patients and special situations: emigrants, foreigners, patient with ill-defined symptoms, with the insane, with the psychotic, with the patient with visual or hearing impairment, at home, with differences of race, social class, gender, etc.). It is concluded that the doctor-patient relationship is a complex, multiple and heterogeneous concept that cannot be defined in a unique way or generalize the concept of “good” relationship, but there are “many doctorpatient relationships” appropriate according to their contexts, which also implies redefining the instruments for measuring this relationship.