Clinician–Patient Relationship

Clinician–Patient Relationship

The roles of healer, helper and physician differ across cultural contexts, and patients may have correspondingly different ex-pectations of their relationship with clinicians, including the duration, level of disclosure, formality and emphasis on techni-cal competence. These expectations often need to be explored, with opportunities for patients and clinicians to negotiate or explain limits to the roles they are able and willing to adopt. Once these differing perspectives are made explicit, a culturally appropriate and professionally acceptable relationship and work-ing alliance can be negotiated.

Clinicians must become aware of their own ethnocultural background and identity and reflect on how it is perceived by patients from their own and different backgrounds. The terms“cultural transference” and “cultural countertransference” have been used to acknowledge that both patient and clinician may have fantasies and responses to the other that are based on earlier relationships with others from that culture or on culturally rooted associations to the other, rather than to strictly personal charac-teristics (Adams, 1996; Comas-Diaz and Jacobsen, 1991).