Physician-patient relationship in the intensive care unit: erosion of the sacred trust?

Full Abstract

With the advent of the increasing technology and multispecialty medicine, the strong relationship or "sacred trust" between patient and family physician has gradually eroded. Various subspecialists are now entrusted with patient care at different phases of evaluation and treatment. Because of the transient nature of these physician-patient interactions, a strong bond is often not established before critical decisions must be made concerning ongoing patient care. As a result, multiple members of the different healthcare teams (the care cooperative) may be confronted with addressing end-of-life discussions, which in the past was the responsibility of the primary physician. Because of this need to move into a previously viewed private territory, communication conflicts may arise between members of the healthcare team. In an effort to understand and deal with observed recurrent problems that occurred when patient care was transferred between specialty care teams, our institution has addressed communication conflicts that arise in the care of oncology patients transferred to the intensive care unit. Our goal has been to initiate and maintain a dialog to avoid misunderstandings and to reduce anxiety between members of the intensivist and oncology services. To this end, we have addressed the various pitfalls that come with the transition from the traditional physician-patient relationship to the more fluid and comprehensive care-cooperative mode. We believe this approach to be useful in improving communication between healthcare providers in the multispecialty care setting, which will ultimately enhance the quality of patient care.

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Author information

Author/s: Chaitin, Elizabeth (E); Stiller, Ronald (R); Jacobs, Samuel (S); Hershl, Joyce (J); Grogen, Tracy (T); Weinberg, Joel (J);

Affiliation: UPMC Health Center, University of Pittsburgh, PA, USA.

Journal and publication information

Publication Type: Journal Article; Review

Journal: Critical care medicine (Crit Care Med), published in United States. (Language: eng)

Reference: 2003-May; vol 31 (issue 5 Suppl) : pp S367-72

Dates: Created 2003/05/28; Completed 2003/06/19; Revised 2005/11/16;

PMID: 12771585, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Communication
Decision Making
Humans
Intensive Care Units - organization & administration
Patient Care Team

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