FInding the Right Doctor
By Mary Anne Dunkin
We all need a doctor – at times many doctors – at different points in our lives. That's especially true when you're dealing with the pain of arthritis. Often the doctor we need is dictated by our condition – and how urgently we need one, says William Buchholz, MD, an oncologist and primary-care physician in Mountain View, Calif., who writes and educates patients about forming positive doctor-patient relationships. “If you have a cut that needs stitches, you just need a technician – any doctor who can stitch the cut and knows to inject Xylocaine.” If you have rheumatoid arthritis, you need a rheumatologist, because a chronic condition may require a lifetime of medical treatment and expertise and technical competence aren’t always enough.
Is a good physician for one person always the right physician for another? Not necessarily, says Edward Krupat, PhD, a Harvard Medical School psychologist whose research has focused largely on the unique nuances of the doctor-patient relationship. Just because a physician is “good,” doesn’t mean he’s right for you. Be it a shared religious belief, common interests or intangible qualities that attract good friends or make people fall in love, for some legitimate – and some inexplicable – reasons certain patients just seem to click with certain doctors.
Doctors feel it, too. “There are some people that you just click with immediately and you know it’s going to be a wonderful match,” says David Watts, MD, a San Francisco physician, poet and regular commentator on National Public Radio’s “All Things Considered.” “Then there are others you just can’t click with, so you just do the best you can.”
Krupat’s fascination with what makes some doctors and patients click began with a personal experience 33 years ago. He and his wife had just moved to Boston and had made same-day appointments to see the same primary care physician. That evening, at home, the two compared notes and discovered vastly different perceptions. “She said he was great and that she was looking forward to seeing him [again],” Krupat recalls. “I said, ‘That’s funny, because I’ve already called and asked for another doctor.’”
While the doctor was in control, comforting and reassuring with both Krupat and his wife, the two saw him differently, simply because their own needs and expectations were different. “Whatever she asked about, he was very reassuring and that was what she needed,” he says. Krupat, on the other hand, was put off by the physician’s paternal style. “I needed information and he wasn’t anxious to give it to me.” The next doctor he found was more forthcoming with information.
The Benefits of a Positive Relationship with Your Doctor
Research shows a positive relationship based on individual needs can pay off in long-term health benefits.
Doctors at the New England Medical Center’s Institute for the Improvement of Medical Care and Health in Boston analyzed data from four clinical trials conducted in practice settings with patients from widely varied socio-economic backgrounds. They found that better health – measured by blood pressure or blood sugar, functional status, or subjective evaluations of overall health status – was consistently related to the quality of the doctor-patient relationship.
