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Physician-Patient Relationship There is considerable healing power in the physician-patient force. A patient who entrusts him(her)self to a physician's care creates ethical obligations that are definite. Working together, the potential exists to pursue interventions that can significantly improve the patient's quality of life and health status. During the second half of the twentieth century, the physician-patient relationship has evolved towards shared decision making. This model respects the patient as a person with a right to hold views, to make decisions, and to take actions based on personal values and beliefs. Patients have been increasingly entitled to weigh the benefits and risks of alternative treatments, including the alternative of no treatment, and to select the alternative that best promotes their own values. Occasionally, a physician may face requests for services which raise a conflict for the physician. Physicians do not have to provide medical services in opposition to their personal beliefs. In addition, it is acceptable to have a nonjudgmental discussion with a patient regarding his(her) need for the service, and to ensure that the patient understands alternative forms of therapy. While the physician may decline to provide the requested service, the patient must be treated as a respected individual. When appropriate, the patient should be provided with resources about how to obtain the desired service. As a patient, you should be able to expect your physician to openly communicate with you. There are several approaches he(she) may use. sitting down attending to the patient's comfort establishing eye contact with the patient listening to the patient without interrupting showing attention with nonverbal cues, such as nodding allowing silences while the patient is searching for words acknowledging and legitimizing feelings explaining and reassuring during examinations asking explicitly if there are other areas of concern Because medicine is a profession and physicians are professionals it is important to have a clear understanding of what it means. The marks of a profession are: competence in a specialized body of knowledge and skill an acknowledgment of specific duties and responsibilities towards the individuals it serves and towards society the right to train, admit, discipline and dismiss its members for failure to sustain competence or observe the duties and responsibilities Professionalism requires that one strive for excellence in the following areas which should be modeled by mentors and teachers and become part of the attitudes, behaviors, and skills related to patient care. A physician is obligated to attend to the best interest of patients, rather than self-interest. Physicians are accountable to their patients, to society on issues of public health, and to their profession. Physicians are obligated to make a commitment to life-long learning. A physician should be available and responsive when "on-call", accepting a commitment to serve within the profession and the community. Physicians should be committed to being fair, truthful, and straightforward in their interactions with patients and the profession. A physician should demonstrate respect for patients and their families, other physicians and team members, medical students, residents, and fellows. While circumstances may arise that hinder adherences to these values, they should provide guidance for promoting professional behavior and for making difficult ethical decisions.

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