Doctors at the New England Medical Center’s Institute for the Improvement of Medical Care and Health in Boston analyzed data from four clinical trials conducted in practice settings with patients from widely varied socioeconomic backgrounds. They found that better health - measured by blood pressure or blood sugar, functional status, or subjective evaluations of overall health status- was consistently related to the quality of the doctor-patient relationship.

“There are several studies that show if the patient feels they have a good relationship with the doctor, blood pressure management is easier, frequency and thus cost of visits is reduced, pain control is more successful,  and the number and cost of medications to keep the patient’s condition under control is reduced,” says Dr. Watts.

“In general, a good doctor-patient relationship is one where there is mutual respect and understanding,” says Dr. Watts. “Certainly in emergencies -- a stabbing or a stroke, for example -- the doctor has to behave as an authority to save lives. But most of the time, we don’t have the pressure of immediate decision making.” Instead, he says, the doctor must work in partnership with the patient, and vice versa.

“This goes contrary to the teaching of most medical students,” says Dr. Watts, “but a good doctor-patient relationship is very much like a good friendship.” That friendship, he says, allows the doctor to talk to the patient about lifestyle issues -- such as quitting smoking or losing weight -- from a position of caring, not solely as a doctor.

Mary Lou Bayer of Pittsburgh, PA., knows this well. The 41-year-old has had osteoarthritis (OA) -- and the same doctor to treat it -- for 17 years. “He managed to get me to quit smoking after 23 years and has me halfway through a weight loss of 50 pounds.” Both changes, she says, have brought improvements to her OA as well as her general health.

Patients who feel at ease talking with their doctor, research shows, are more likely to comply with the doctor’s recommendations, and take prescribed medications, compared to patients who clam up in the examining room. Maura Daly Iversen, a physical therapist and an instructor of medicine at Brigham and Women’s Hospital in Boston, has observed this firsthand, teaching patient-provider communication. She has also witnessed it with her teenage daughter, Christina, who has juvenile rheumatoid arthritis.

Early in the course of her daughter’s disease, Iversen sought a doctor who was considered to be the top expert in the field. It didn’t take long to discover the best expert wasn’t necessarily the best fit. The next doctor they chose, however, was just what her daughter needed. “When I take her to the doctor now, she kicks me out of the examining room. Her doctor can elicit information about everything,” says Iversen. “Christina is very adherent to her treatment plan. I don’t even have to remind her to take her medicine any more.”