Perceptions about changes in the doctor-patient relationship during the COVID-19 pandemic in the light of medical narratives

Abstract

Introduction: The doctor-patient relationship (DPR) has been extensively studied over the years, and there is a consensus on its importance in medical practice. At the end of 2019, the world began to fight the pandemic caused by the new coronavirus, whose main form of transmission is direct contact between individuals. Transmission control measures were adopted, but they impacted the way DPR used to be. Family physicians, working in primary health care, served on the front lines of the pandemic. They are often committed to DPR, and some have written their pandemic narratives on the "Causos Clínicos" blog. Faced with this moment, the idea arose of scrutinizing the nuances of the DPR in the light of the narratives of those who lived this process on the front lines. Objective: This study aimed to analyze the perception of family physicians in the DPR during the COVID-19 pandemic. Methods: A qualitative study was conducted, where we evaluated medical narratives published on "Causos Clínicos" through content analysis. The corpus of analysis went through three stages: pre-analysis, analytical description and referential interpretation. Results: After the selection of the corpus, 42 narratives were considered for the analytical process, in which the codes identified were: “barriers and difficulties” and “strengths and confrontations”. Some barriers were then detected, such as: conflicting emotions of personal mental health and also related to the physician's social role; the need for social distancing, reducing physical contact; and changes in the health system typical of this period, such as the persistence of clinical and social demands, reduced availability of face-to-face consultations and insufficient basic protection supplies. The ways of coping identified were: exercising empathy; qualified listening, attentive look and communication skills, in addition to the use of telemedicine. The information from the literature corroborates the results obtained in this study. As for the limitations, this study only looked at the physician's point of view and gathered other relevant information on the subject, which could not be included in the results. Conclusions: It is possible to say that the DPR changed during the pandemic, but the narratives show that even in times of crisis, it is possible to establish significant links between the doctor and the patient. These results may contribute as a coping measure for new public health crises in the future.