6.1 The Patient–Practitioner Relationship

2026 📋 Syllabus Objectives

By the end of these notes, you should be able to:

  1. Explain interpersonal skills in healthcare — including non-verbal communication (clothing) and verbal communication (medical terminology)
  2. Describe diagnosis and style — including disclosure, and the difference between doctor-centred and patient-centred approaches (Savage and Armstrong, 1990)
  3. Explain misusing health services — including delay in seeking treatment, Munchausen syndrome, and malingering

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Objective 1: Interpersonal Skills in Healthcare

What are interpersonal skills? Interpersonal skills are the ways people communicate and interact with each other. In healthcare, the way a doctor or nurse communicates with a patient has a huge effect on:

  • Whether the patient feels comfortable
  • Whether the patient trusts the practitioner
  • Whether the patient follows medical advice
  • Whether the patient shares all relevant information about their health

Communication can be split into two types: non-verbal (without words) and verbal (using words).

🔹 Non-Verbal Communication: Clothing

Non-verbal communication means sending messages without speaking — through appearance, body language, facial expressions, and gestures. In healthcare, clothing is one of the most important non-verbal signals.

Why does clothing matter?

The clothes a healthcare practitioner wears give the patient immediate impressions — even before a single word is spoken. These impressions affect the patient's trust, comfort, and willingness to share personal health information.

The traditional view — formal/professional dress:

  • Doctors wearing a white coat or formal attire signal professionalism and authority
  • Patients are more likely to trust a doctor who looks like a doctor
  • Formal dress creates a clear role boundary — the patient knows who is in charge of their care
  • Research supports the idea that patients often feel more confident in practitioners who dress formally

The modern view — informal/casual dress:

  • Some practitioners (especially those working with children or mental health patients) choose casual, colourful clothing to appear less intimidating
  • This can make patients feel more relaxed and able to open up
  • However, casual dress may reduce perceptions of competence and authority

The key tension: There is a balance to strike. Overly formal clothing may feel cold or intimidating; overly casual clothing may seem unprofessional. The right clothing choice depends on context (e.g., who the patient is, what kind of treatment is needed).

Example: A paediatric nurse (a nurse who works with children) might wear bright, cartoon-patterned scrubs to seem friendly and less scary to a frightened 6-year-old. A surgeon in an operating theatre, however, would wear sterile scrubs and a white coat to signal hygiene and medical authority.

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