The 5 Stages of the Doctor-Patient Relationship

The traditional notion of the doctor-patient relationship is under stress and people are searching for ways to repair it.

It turns out there are 5 stages to a relationship:

• The Romance Stage

• The Power Struggle Stage

• The Stability Stage

• The Commitment Stage

• The Co-Creation or Bliss Stage

In many ways, doctors and patients fail to progress and work through the issues and often wind up getting divorced or standing in front of a judge or jury. The results are just as painful, injurious, and enduring. Doctors and patients need to find a better way to get along. Of course, the doctor-patient relationship varies from a romantic one in many ways, including the fact that the doctor has a fiduciary relationship to the patient and is subject to tort remedies if they violate it. However, there are things we might learn from the family and couples therapists:

1. They need to improve how they communicate with each other.

2. They need to take personal responsibility and not rely on someone else or "the system" to do it for them.

3. They need to call a time out when things get rough and possibly call in a mediator or third party to help.

4. They need to walk in each other's shoes and understand each other's issues.

5. They need to understand where they are in the Sick Care ecosystem and the unrecognized elements that drive health behaviors, like nutrition, public health interventions, poverty, and education

6. They need to understand that you are having a relationship with a family, not just a person. Care teams take care of patient teams.

7. They need to learn how to cut their losses when it is evident it is time to pull the plug and move on.

8. They need to learn to adopt to the changing rules of the power struggle.

9. They need to learn how to partner to be a team moving forward.

10. They need to accept the fact, that, like long-married couples, they stay together because they want to.

Many of you readers are "in a relationship." Some just want to hook-up and others are looking for more commitment. Doctors and patients need to understand that if we are to fix the deteriorating doctor-patient relationship, it will take hard work and there will be many bumps in the road.