Personal views

Pleasing doctors: when it gets in the way

BMJ 2007; 335 doi: 10.1136/bmj.39325.646887.94 (Published 6 September 2007)
Cite this as: BMJ 2007;335:514

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  1. Robert Klitzman, associate professor of clinical psychiatry, College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York
  1. rlk2{at}columbia.edu

    “You want your doctors to like you,” she said. “You want to be a good patient and sometimes are afraid to rock the boat.” The woman speaking to me was a physician with cancer. I was interviewing her as part of a study of doctors who had become sick with serious disease.1 To my surprise, she and others I talked to described repeatedly how they hesitated to be aggressive or “pushy” with their own healthcare providers and instead tried to please them.

    “If I trust the doctor,” another doctor with cancer told me, “he feels good. The fewer questions I ask, the happier he is and the more positive he'll relate to me. I want him to know he's a good guy.”

    In general, people want others in social interactions to feel positively, and doctor-patient interactions are no exception. Unfortunately such behaviour can hamper open communication between patients and their providers and hence impair care.

    The best doctor-patient communication can enhance interpersonal relationships, information exchange, medical decision making, informed consent, and patients' satisfaction, adherence, understanding, and, possibly, health outcomes.2 3 4

    As another …

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