PHYSICIAN-PATIENT RELATIONSHIP: IS IT SUFFICIENT FOR THE EFFECTIVE PRACTICE OF MEDICINE?

Epidemiological investigation of the several component major commands of Seventh Army reveals that during 1954:

1. The incidence of infectious disease does not appear to correlate with the incidence of behavior and social problems, or with accidents.

2. Commands having higher rates for selected behavior and social problems have had more accidents.

3. Commands that utilized in a less than average manner the available Mental Hygiene Consultation Service had a lower than average rate of "368-369" discharges, and a higher incidence rate of disciplinary reports, courts martial, and crimes and offenses. They also had a higher than average incidence of cold injuries.

Obviously few final conclusions should be drawn from a solely statistical study of only one year's experience, or too firm convictions as to the factors that should be measured, or the means we should utilize for their evaluation. There seem to be potentially useful techniques demonstrated which we may project and improve by further study. Probably only in the military service can these methods and techniques be initiated and developed effectively and rapidly.

The effects of the community on the person and the person on the community can be more thoroughly understood and should be considered when the individual physician undertakes treatment of the individual patient, whether in his home, at the physician's office, in dispensaries, or in hospitals. The average practicing physician should be able to count on those having the capabilities and opportunities to develop the best possible techniques for aiding him along this line. However, after such techniques are developed, can we expect expansion of the process to maximum effectiveness in the military service and in the civilian practice of medicine?

Every physician should make certain that the term "physician-patient" relationship takes full cognizance of the broader meaning just discussed. The illness of the community manifests itself in the form of the patients' physical or mental disease, behavior or social problems, or in the occurrence of accidents. The physician should utilize all the available knowledge of community illness. In doing so, he should consider that the patient requires treatment because the community has failed to prevent his ill. If the physician can succeed in these objectives each patient should return earlier and more effectively to a gratifying and productive participation in the community existence. Could a physician hope to achieve more?