Exploring the relational aspects of patient and doctor communication

The alliance concept is an essential component of therapeutic relationships. Contrary to empirical evidence, its relevance is often not acknowledged in medical encounters. This circumstance invites the question, “How can the doctor and patient connect relationally with each other to improve the communication process and promote healing?” We propose that healing can be accomplished through dialog that emphasizes the collaborative nature of the partnership between the doctor and patient. The typical conversation in a medical encounter may be reduced to an information exchange and a medium for prescribing directives. This being-with approach can override patients’ involvement in the process. A positive doctor–patient relationship may be one of the most important, and most frequently overlooked, factors for predicting patient response to negative medical information. Receiving such news is potentially upsetting for the patient and may require the doctor to let go of the conversational medical agenda and adopt a being-for mode of relationship. We propose that this approach invites the doctor and patient to work together and negotiate how to manage the chronic illness eliciting patient-preferred treatment options. The authors propose the adoption of the being-for relationship as a way of enhancing the therapeutic potential of the doctor–patient relationship.