DEVELOPING, VALIDATING AND CONSOLIDATING THE DOCTOR-PATIENT-RELATIONSHIP - THE PATIENTS VIEWS OF A DYNAMIC PROCESS

Background. Previous research has examined the doctor-patient relation ship in terms of its therapeutic effect, the need to consider the pati ents' models of their illness, and the patients' expectations of their doctor. However, to date, no research has examined the patients' view s of the doctor-patient relationship. Aim. To examine patients' views of the process of creating a relationship with their general practitio ner (GP). Method A qualitative design was used involving in-depth inte rviews with 27 frequently attending patients from four urban general p ractices. They were chosen to provide a heterogeneous group in terms o f age, sex, and ethnicity Results. The responders described creating t he relationship in terms of three stages: development, validation, and consolidation. The development stage involved overcoming initial rese rvations, actively searching for a doctor that met the patient's needs , or knowing from the start that the doctor was the right one for them . The validation stage involved evaluating the nature of the relations hip by searching for evidence of caring, comparing their doctor with o thers, storing key events for illustration of the value of the relatio nship, recruiting the views of others to support their own perspective s, and the willingness to make tradeoffs. The consolidation stage invo lved testing and setting boundaries concerned with knowledge, power, a nd a personal relationship. Conclusion. Creating a relationship with a GP is a dynamic process involving an active patient who searches out a GP who matches their own representation of the 'ideal': selects and retains information to validate their choice, and locates mutually acc eptable boundaries.