Doctor-Patient Relationship in General Medicine Has a Diagnostic Meaning

  • Jose Luis Turabian Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain.
Keywords: General Practice, Framework, Diagnostic techniques, Sanitary Attention, Physician-patient communication, Physician-Patient Relations, Symptom assessment, Biopsychosocial


The doctor-patient relationship is not only based on the contributions of the doctor, or only based on the patient's, but is formed through the interaction of the contributions of both. But, the relationship that the patient tends to create with the doctor has a latent meaning concerning the reason for that patient's consultation. That is, it has a diagnostic meaning. In this way, the general practitioner (GP) can search for information about what seems to be the cause of the patient's problem, in addition to other sources, based on the type of relationship that the patient establishes with him. In this way, the patient's interpersonal relationship can be reproduced in the consultation, between patient and doctor. So, the type of doctor-patient relationship, which tends to be created by the patient, partially points out the content of the latent material of reason for the consultation; it partially points to the diagnosis. Thus, the following types of patient's relationship with the doctor in the clinical encounter can be observed: 1) "Dependent relationship"; 2) "Manipulative relationship"; 3) "Demanding or angry relationship"; 4) "Victim relationship"; 5) "Distant relationship"; 6) "Relationship with excessive familiarity or closeness"; 7) "Submissive relationship"; 8) "Masochistic relationship"; 9) "Sadistic relationship": 10) "Hyperactive or impatient relationship"; 11) "Indifferent relationship"; 12) "Narcissistic relationship"; Etc. If the GP passes through the doctor-patient relationship as blind to its existence, without realizing it, using only a medical model that explicitly directs its attention away from this doctor-patient relationship, it will lose many possibilities to understand the consultation, among them, an important one that is not mentioned: the possibility of orienting the diagnosis in general medicine.