Indian Journal of PsychiatryIndian Journal of Psychiatry
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Year : 2019  |  Volume : 61  |  Issue : 10  |  Page : 776-781

The enigma of doctor-patient relationship


1 Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
2 Foundation for Research and Advocacy in Mental Health (FRAMe), Mysore, Karnataka, India
3 Spandana Health Care, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Mahesh Gowda
Spandana Health Care, 236/2, 29th Main, Nandini Layout, Bengaluru - 560 096, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_96_19

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The doctor–patient relationship is crucial to the health-care delivery. In the past, the relationship was viewed as one between a healer and a sick person. However, in the modern era, it is seen as an interaction between a care provider and a service user. The Mental Healthcare Act (MHCA) 2017 gives importance to rights and provision for more autonomy to patients. We examined, in the context of the existing literature, the potential impact the implementation of MHCA 2017 can have on the doctor–patient relationship. A bond between doctor and patient that is based on trust has been an integral part of patient care and has been described to promote recovery, reduce relapse, and enhance treatment adherence. Growing mistrust among patients toward doctors leads them to change their doctors frequently, and due to this, the patients are at risk of losing the therapeutic benefit of the doctor–patient relationship. The doctor–patient relationship has been understudied in areas of health-care need, such as in rural areas, where accessibility and availability of care itself become the most important goal. Medical advancement, with several new treatment options, as well as the availability of many experts for patients to choose from, seems a boon turning into a bane. MHCA 2017 and other health-care policies so far have not given importance to this relationship that is being damaged by several factors including rising health-care costs, especially in private sector and after patients have become “consumers.” However, for now, the foremost thing is the psychiatrists have to work to comply with the law and document to justify clinical decisions.



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