The physician leader as guardian of the physician-patient relationship

Thoughts and ideas from The Physician Executive
The physician leader as guardian of the physician-patient relationship
September 6, 2017 at 12:00 AM
by The Physician Executive
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This week’s email from Paul Keckley (Managing Editor of The Keckley Report, a healthcare researcher and widely known industry expert) reminded me of just how critical your role is as a physician leader in protecting the physician-patient relationship.

Keckley writes:

The physician-patient relationship has been widely studied. A framework developed by Ezekiel and Linda Manuel(*JAMA subscription needed for full article) has been widely used to categorize the four roles physician play in these relationships: guardian, technical expert, counselor, and friend. In interacting with patients, physicians play all four. Researchers have linked a physician’s personality with their bedside manner. Surveys show most physicians lean toward a more paternalistic approach in dealing with patients and the majority think friendships with patients must be approached with caution. Academics have studied the dynamic between physicians and patients, observing that the physician is the ‘power’ figure in most.
*my added words, and bolding

He goes on to highlight factors impacting and changing the dynamics of that intimate and powerful relationship, about which you as a physician leader are undoubtedly aware.

What does this mean for you as a physician leader?

I believe that one of the cornerstones of your role, be that of Medical Director, Chief Medical Officer or any other physician leader role within your organization, is to advocate fiercely for the sanctity of the physician-patient relationship.

You are its Guardian.

Yes, you have to implement corporate initiatives, and yes, there are all kinds of financial pressures requiring you, as a clinician AND administrative representative, to be a thoughtful steward of your organization’s and our society’s resources.

Underneath all of that lies a truth that only you and your clinical colleagues know. You know just how precious and valuable that most intimate relationship is, and what delicacy and trust are required to navigate its waters successfully.

That, I argue, is your most important role!

I welcome other points of view in the comments, AND I encourage all you physician leaders to sign up for the weekly memo, AKA the Keckley Report (it’s free, well thought-out and easy to digest).