Doctor-patient relationship key

The doctor-patient relationship is a very important cornerstone of healthcare. It extends far beyond provision of clinical services and is a critical partnership that requires a high level of trust and comfort. As a gynaecologist, my relationship with my patients often begins when they are about to embark on one of the most beautiful journeys of their lives – pregnancy and childbirth.

Through the nine months of pregnancy to the delivery of the baby to when the baby is five years old and even up until the next pregnancy, my equation with my patients only gets stronger with time.

I become their partner as they progress through parenthood and make a conscious effort to devote adequate time to address their needs and questions concerning their own health and that of their child’s.

Part of the reason why I have a great association with my patients is because I am not just their service provider. Aside from diagnosis and treatment, I look into their other interests and well-being as well.

For example, a couple who is pregnant for the first time needs to be prepared for the arrival of the baby, and as their doctor, it is my duty to counsel them, to manage their expectations and to ensure they take proper antenatal classes that will help them prepare for labour, birth and parenthood.

The counselling and training also needs to extend to the fathers and the entire family, so they are well prepared on how to take care of the newborn baby and the new mother.
This is particularly important in the Indian context, where the father plays a very important role but many do not feel comfortable opening up to a gynaecologist and sharing their concerns. A pregnant couple’s healthcare provider can encourage fathers to participate in the antenatal process by educating them on its importance of bonding with the child.

While pregnancy and child birth is a wonderful experience, it can also be slightly overwhelming at times for the pregnant mother. Her body goes through hormonal and physical changes, she suffers from pregnancy side-effects like morning sickness and she might feel stressed about managing everything when the baby arrives. The stress is further amplified in case of a high risk pregnancy.

In my experience, the stress women go through during pregnancy can be largely mitigated if the obstetrician is more like a friend to the patient.

The concept of joint families is largely prevalent in Indian households which can be extremely beneficial to the pregnant mother as she needs ample support during this period, especially from her husband, her parents and her in-laws.

Counselling parents
The relationship between a gynaecologist and a patient does not end with childbirth. In fact, the post-natal period is as important as the ante-natal period and delivery. During this time, the doctor needs to counsel the new parents on how they should space their next pregnancy should they plan to have another child.

Many new mothers struggle with breast-feeding initially and require their doctor’s assistance in getting the baby to take the breast. New parents can easily get worried over the slightest issues concerning their baby, so the doctor needs to be patient during this time and resolve the patient’s issue, no matter how small it might be.

While the importance of a doctor being a people’s person might not have been given much attention in the past, today it helps if a doctor is empathetic and has a certain level of social and self-awareness so that ultimately she/he is able to better understand and respond to a patient’s frailties, fears and aspirations. This is particularly relevant in obstetrics and gynaecology, where a doctor-patient relationship has the potential to last for years.

From a clinical perspective, when a doctor has been treating a patient for a long duration, over time she/he is able to recognise behavioural patterns and disease trends in the patient and the patient’s family and might be in a better position to prevent certain diseases and conditions.

Each year, India and several other countries observe Doctors’ Day to acknowledge the valuable role they play in improving the lives of their patients. This Doctors’ Day, my message to my fellow doctors is that they should make a conscious effort to cultivate their relationship with their patients as that can have a profound impact on both medical and social outcomes.

(The writer is Chief of Obstetrics and Gynecology, Cloudnine Hospitals, Bengaluru)