Re-forming relationships in health care

Relationships among members of a medical team, between a patient and his caregivers, and between a medical team and a patient's family and social support network are crucial to the delivery of health care and to patient satisfaction with that care.

The Regenstrief Institute Inc. hosted nearly 100 of the nation's top scientists in an interdisciplinary conference to discuss research on relationship-centered care. The findings of the conference are reported in a special supplement to the January issue of the Journal of General Internal Medicine.

Thomas Inui, M.D., president of the Regenstrief Institute, Inc. and associate dean for health services research at the Indiana University School of Medicine, and Professor of Medicine Richard Frankel, Ph.D., a research scientist at the Regenstrief Institute and at the Center for Implementing Evidence Based Practice at the Roudebush VA Medical Center, chaired the Ninth Biannual Regenstrief Conference entitled "Re-Forming Relationships in Health Care: Creating a National Research Agenda for Relationship Centered Care."

Presentations by experts representing a wide range of specialties included discussions of the influence of information technology on patient-physician relationships, training of future physicians, and expression of emotion during medical visits. An editorial in the supplement by F. Daniel Duffy, a senior vice president at the American Board of Internal Medicine, notes that it has taken a decade for relationship-centered care to secure attention and that it will take another decade for it to be effectively studied.

"What we have found repeatedly is that medical care succeeds when there are stable and enduring relationships," says Dr. Frankel.

"Successful outcomes lie not simply in the mechanics of medical care, but in the social and emotional context of the doctor patient relationship. For example, a medical test might reveal that a patient has a condition requiring a significant change in diet. The doctor must develop a working relationship with the patient if the treatment is to succeed. Simply telling someone to control his dietary intake, without knowing the individual, doesn't work."