With the doctor-patient relationship the theme of APA’s 2000 annual meeting, former APA president John McIntyre, M.D., described nine "essential qualities" that a physician needs to forge a successful relationship with each patient.

These qualities, which he emphasized "are not fuzzy, but are evidenced based and can be studied," are the following:

• A caring attitude

• Respect for the patient as a person, a key element of which is "respecting appropriate boundaries"

• Attentiveness to what the patient is conveying

• Responsiveness to patients’ need for feedback about the issues and concerns they share with their physician

• Having expertise about all aspects of a patient’s illness and sharing it with the patient and significant others in the patient’s life

• Strict adherence to preserving confidentiality, even in the face of "tremendous assaults" against it

• Reliability and consistency in responding to each patient’s needs

• Availability to patients and their families

• Advocacy on behalf of patients.

To illustrate how these qualities coincide with what patients want from their relationship with a physician, McIntyre cited the results of a survey of more than 350,000 individuals conducted by the Picker Foundation. That study found that patients listed the following factors as important to their satisfaction with their physician:

• Respect for their values, preferences, and needs

• Access to care

• Emotional support

• Information and education about their medical problem

• Care that is coordinated and does not require them to go from specialist to specialist

• Attention to their physical comfort during appointments

• Involvement of family or friends in their care

• Continuity rather than disruptions of care if transitions are required

McIntyre is chair of the APA committee that oversees the development of practice guidelines and chair of the psychiatry department at Unity Health Systems in Rochester, N.Y. He is also a clinical professor of psychiatry at the University of Rochester School of Medicine.