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April 16, 2001 -- A strong relationship with your doctor doesn't just make office visits more pleasant -- it's key to having better health. But how is this possible in today's environment, when healthcare seems to be getting ever more streamlined and impersonal?

"It is a collaborative [relationship], not us vs. them," Zeev E. Neuwirth, MD, tells WebMD. "If you approach physicians with this idea, tell them 'I want us to be on the same team, and working together. I want to get to know you, and I want you to know me, and I want for us to be more than cogs in this healthcare machine.'"

Neuwirth, an internist and medical educator at New York's Lenox Hill Hospital and assistant professor of medicine at New York University, is an expert in doctor-patient relationships. So are University of Chicago professor Wendy Levinson, MD, and University of Rochester professor Anthony L. Suchman, MD. All three agree that the doctor-patient relationship has a direct effect on the patient's health. And all three say that lots of things have to change.

The Accountant Will See You Now

Levinson worries about one recent development: the influence of money on patient trust in their doctors. At a recent meeting of the American College of Physicians/American Society of Internal Medicine, she talked about her ongoing research in this area.

"What was really striking to us was that doctors told us repeatedly that managed care and financial arrangements were really affecting how they viewed their role [with their patients]," Levinson says. "One doctor said he felt like a vending machine. He said that patients were coming in with lists of medicines and they really wanted him to just give them what they needed. There is real groundswell among physicians in how they see their role changing to being such a vending machine instead of a trusted advisor."

Suchman agrees. He says that the current healthcare system that stresses cost containment over patient care has created an artificial environment where a doctor can no longer see a patient as real person, whether they want to or not.

"I worked for 15 years studying my own patient-communication skills and learning how to teach them [to others] -- but after all that work I didn't see the [healthcare] world changing very much," Suchman says. "I began to see how healthcare organizations treat people: they create this force field of depersonalization. So if you are depersonalized, it is hard to treat your patient like a person. On the emotional and interpersonal level, the practice of healthcare [today] is primitive."

The Well-Informed Patient

Levinson, Suchman, and Neuwirth each talk about how the roles of doctors and their patients are changing. They all say one factor in this changing doctor-patient relationship is the rise of Internet health sites that provide patients with state-of-the-art health information.

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