Physicians like the majority of their patients, but often they like certain patients more than others, a study led by researchers at the Johns Hopkins Bloomberg School of Public Health finds.
The researchers say that understanding the physician-patient relationship may provide insight into how patients and physicians can best work with each other, from patients making sure they see their doctors regularly and doctors appreciating the rewards of their practice, thus avoiding burnout. The study is published online in the journal Patient Education and Counseling and is thought to be among the first to explore the positive aspects of physicians' attitudes toward their patients.
"For patients, these findings highlight the importance of having a usual source of care, a primary care doctor with whom they can establish a relationship," says study leader Joy Lee, a postdoctoral fellow in the Department of Health Policy and Management at the Bloomberg School. "Favorite patients might not be consistently sick, but when a crisis comes they have an existing relationship to work off of."
For the study, researchers interviewed 25 physicians, with 22 respondents reporting having favorite patients. Surprisingly, Lee says, many of the physicians who reported having a favorite noted that those patients were not necessarily the most compliant. Rather, they were patients the physician had known over a period of time—anywhere from one year to several decades—and who were or had been very sick, which meant the physicians saw them more frequently and spent more time with them.
The physicians in the study, including the three who reported not having a favorite patient, voiced concerns that the label of "favorite" suggested preferential treatment. In their responses, physicians often indicated that they aim to provide all patients the best care, regardless of their feelings about them—favorable or otherwise. In fact, the only perceived benefit for favorite patients might be that their physicians, having spent significant amounts of time with them, are best suited to care for their patients because of their knowledge of their cases. Otherwise, physicians did not identify substantial benefits favorite patients had over others.
"This concern demonstrates that physicians are striving to be fair and to give all their patients the best possible care," Lee says. "We discovered that doctors really thought about their relationship with patients, which is encouraging from a patient perspective. Their thinking really humanizes the patient-physician relationship."
The findings emphasize the importance of consistent access to health care so patients can see the same physician over time. The researchers note that uninsured patients tend to see a variety of physicians and often seek treatment at emergency rooms instead of specific practices, thus diminishing the likelihood of developing relationships with their doctors.
Many physicians in the study reported that formerly challenging patients often became their favorites over time, reinforcing the benefits of patients seeing the same physician when possible.
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