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Building a therapeutic physician-patient relationship

By Gracie Awalt

The practice of plastic surgery often produces uncertainties. Patients judge the success of surgical outcomes based on their personal standards, so it is important to manage any misconceptions patients may have about outcomes through communication.1

A therapeutic relationship fosters “personal awareness and insight, trust, respect, safety, authenticity, acceptance, empathy, and collaborative agreement.”2 Establishing this type of relationship with patients can help reduce medical liability risk by creating a shared understanding of uncertainties, motives, and emotions through the clinical process.

In a 2016 study, 17 physicians were interviewed about relationships with patients that produced successful outcomes. The researchers then analyzed these interviews to develop a model describing successful physician-patient relationships.3


Value the patient

Physicians who actively valued each patient as a person by exhibiting non-judgmental behavior, communicating effectively, and being fully present mentally in clinical situations proved successful. Be considerate of the different cultural or social class circumstances that affect each patient. Practice empathy, try to connect with the patent through shared human experiences, and avoid objectifying the patient. Lastly, dedicate full attention to the patient when they’re describing their condition, and practice active listening.3

Shared decision-making

Engaging in shared decision-making proved useful for the interviewed physicians and their patients. Patients felt like they had agency over their condition when they or relevant members of their family were involved. Educating patients about complex medical terminology and procedures also helps patients feel more knowledgeable. Provide context for decisions and guidance through good teaching about the patient’s condition and options.3

Commit to the patient

Continuing a relationship with a patient creates a feeling of familiarity and common history, building intimacy and trust over time. Be available and present for the patient during critical situations, even when a negative outcome cannot be avoided.3

Exhibit confidence and competence

Patients feel comforted by a physician who is confident in the treatment process and diagnosis, so provide assurance to the patient when appropriate. Manage personal emotions by being mindful of their basis, and control emotions towards patients to promote a sense of calm. Consider the external and internal factors that may affect the patient’s behavior, and be mindful of feelings of fear, anxiety, regret or guilt in the patient. Lastly, be transparent with patients about limitations in knowledge and skills that prompt the need to consult with other practitioners.3

Overall outcomes

The research found these practices formed relationships by building trust, promoting a sense of peace, instilling hope in the patient and allowing the patient to feel acknowledged.3 The plastic surgeons can benefit by focusing on relationships, as each patient’s expectations and needs vary widely.



  1. What You May Not Have Learned in Your Residency: What every plastic surgery resident needs to know. The Doctors Company. Available at Accessed May 6, 2020.
  2. Definition of therapeutic relationship. The Free Dictionary by Farlex: Medical Dictionary. Available at Accessed May 6, 2020.
  3. Razzaghi MR, Afshar L. A Conceptual Model of Physician-Patient Relationships: A Qualitative Study. Journal of Medical Ethics and History of Medicine. November 8, 2016. Available at Accessed May 6, 2020.