Patient is usually impatient. The anxiety associated with symptoms and potential diseases makes patients highly frustrated. Adding to this is pain of waiting in doctor’s clinic and subsequently undergoing multiple investigations to get the final diagnosis. Moreover, at this stage he is unsure of the symptoms relief and future prognosis. Thus, cumulative thinking and emotions in patient’s mind about his illness outburst in form his behavioral expressions affecting doctor-patient relationship. It often leads to misunderstanding between doctor- patient interactions.
Interestingly these behavioral patterns and expressions in patients varies depending on their socio-economic class, literacy, gender, rural and urban setting and even geographies across the globe. Further, the same patient behaves differently in different healthcare settings like private clinics, government hospitals, charitable trust hospital and corporate hospitals. The preset expectations of the patients from different settings accordingly modifies his behavioral response leading to several undesirable facts. Patient may have a tendency to hide the facts related to his illness or sometimes exaggerate the feelings out of proportion challenging the doctor’s assessment about his disease. Patient often consider doctor as a programmed robot who should know solutions to his all problems. Unaware of the fact that medicine is not a mathematics not based on numbers or theorem. Medicine is a science that may differ for each patient and even for the same illness. Human body is a mix of heterogenous elements that varies from person to person depending not only on age and gender but also on his physical, mental, social and spiritual status at the time of disease.
The disease perception varies from patient to patient for the same illness. Adding to the malady is patients with medically unexplained symptoms that puzzles the doctor without any immediate remedy. One set of such patient will anxiously ask for all investigations possible to exclude any serious illness. This often leads to series of investigations without any clinical diagnosis. On the other hand, few such patients will refrain going for any investigations even the basic screening. This could result into missed diagnosis for a chronic condition.
Increased access of information in this era to the patients has helped them for a better and healthy living but also added misery in their thinking about symptoms or any disease. They communicate their sufferings to the doctor more to judge his knowledge than actual problem. It is said that majority of diseases can be diagnosed by taking a systematic and detailed medical history. The art of history taking and its importance in diagnosing an illness cannot be overemphasized even in the era of advanced technologies. Patient usually do not understand the significance of this communication and narrates the problem in his own way. At times during his narration doctor has to intervene to bring to him to the point of interest. It is seen that patient narration about his symptoms depends on his perception of disease and educational background and not necessarily actual problems. Doctor has to struggle a lot to get the right symptoms from patient that can indicate the disease. Not uncommonly the clue to the diagnosis are made based on past medical history, his treatment history or even drug labels that he carries along for the doctor’s consultation.