Clinician–patient relationships after two decades of a paradigm of patient-centered care

Background: Despite well-known advancements in medicine, there is rather little known about the effects of patient-centered care on clinician-patient encounters. The aim of this narrative study is to explore interactive competencies in diagnostic and therapeutic encounters and intake protocols from the perspectives of physicians, nurses and medical receptionists. Methods: Three data sets including 13 participant interviews, policy documents and a website were used. Further triangulated analyses, including N-Vivo, manifest and latent, Mishler’s narrative elements and Charon’s narrative themes, in recursive, overlapping, comparative and intersected analysis strategies were employed. Results: A common factor affecting physicians’ relationships with their clients was limitation of time. For almost all nurse participants in the study establishing therapeutic relationships meant being compassionate and empathetic. The goals of intake protocols for the medical receptionists were about being empathetic, listening attentively, developing rapport, and being polite to patients. Conclusion: Patient-centeredness has emerged as a discourse practice, with nebulous enactment of its premises in most clinical settings. The healing power of effective communication is well-known but the scientific affirmation of it is scarce. More research has to be undertaken to better define and understand the role of good narration in terms of outcomes with regards to diseases and illnesses.