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In these circumstances and also in cases where there is genuine divergence of medical opinions, a second opinion from another physician may be sought or the patient may choose to go to another physician that they trust more.
Does giving a sugar pill lead to an undermining of trust between doctor and patient?
Is deceiving a patient for his or her own good compatible with a respectful and consent-based doctor–patient relationship?
The physician may be viewed as superior to the patient simply because physicians tend to use big words and concepts to put him or herself in a position above the patient.
The physician–patient relationship is also complicated by the patient's suffering (patient derives from the Latin patior, "suffer") and limited ability to relieve it on his or her own, potentially resulting in a state of desperation and dependency on the physician.
Enhancing the accuracy of the diagnosis and increasing the patient's knowledge about the disease all come with a good relationship between the doctor and the patient.
Where such a relationship is poor the physician's ability to make a full assessment is compromised and the patient is more likely to distrust the diagnosis and proposed treatment, causing decreased compliance to actually follow the medical advice which results in bad health outcomes.
At one end of this spectrum is Beck's Negotiated Approach to risk communication, in which the communicator maintains an open dialogue with the patient and settles on a compromise on which both patient and physician agree.
A majority of physicians employ a variation of this communication model to some degree, as it is only with this technique that a doctor can maintain the open cooperation of his or her patient.
A patient must have confidence in the competence of their physician and must feel that they can confide in him or her.
For most physicians, the establishment of good rapport with a patient is important.