Virtual Reality in Patient-Physician Relationships

Introduction

The patient-physician relationship has been a hot topic in medicine for a long time. It ranks second in importance only to family relationships and is considered more important than relationships with colleagues or advisers (Pincock, 2003). Doctors are also seen as the most trusted source of health information. This trust between doctors and patients sets up the foundation for their further collaboration and affects the treatment outcome directly (Baron and Berinsky, 2019). For example, a high-quality patient-physician relationship improves patient engagement in Human Immunodeficiency Virus (HIV) care (Flickinger et al., 2013). Specifically, HIV patients keep more appointments if providers treat them with respect, know them as people, listen carefully, and explain so that they can understand. Moreover, improving doctors' communication and relationship-building skills may increase patient retention in HIV care.

Many factors may affect the relationship between doctors and patients, and an essential one is communication between the two parties. According to Persaud (2005), effective communication is at the heart of the physician-patient relationship. Doctors have to be, in a sense, bilingual: They must learn the technical terminology to start a medical dialogue with colleagues; simultaneously, they must also learn to communicate with patients. However, it is sometimes unavoidable for doctors to employ technical terms in communication with patients. Doctors are trained for years and equipped with expert knowledge, but patients usually lack this expertise. As a result, patients have a tough time understanding the message that doctors try to deliver, and they also have difficulty expressing their feelings.

Poor patient-physician relationships can cause losses for both patients and doctors. On the patients’ side, delayed diagnosis and treatment of conditions can endanger health and life, while unnecessary monetary costs may be incurred. On the doctors’ side, the reputation of them and their hospitals may be damaged, and the daily operations of the hospitals can be affected.

Even worse, violence against doctors due to mistrust or conflicts has been an increasing issue in China (The Lancet, 2010, 2012), and these incidents can happen at different stages of treatment. The case of Wenbin Sun, for example, happened during the treatment process. Sun's mother was taken to Civil Aviation General Hospital on 4 December 2019 because of dysphagia. His mother did not get better during the treatment and had to stay in the hospital for observation. Sun did not correctly understand his mother's state at that moment, blamed the doctor for the lack of improvement in her condition, and attacked the doctor with a knife publicly in the hospital's emergency department. The example of Mingjun Yuan, by contrast, happened after the treatment process. Yuan went to Lanzhou Wuzhou Psoriasis Hospital for a course of pigmentation treatment. When the effect of the treatment did not meet Yuan’s expectations, he did not consider it rationally. Hence, he became angry with the doctor and murdered him.

All the above examples suggest that medicine is a sophisticated science, and at the same time, it is not a panacea. This complexity characteristic of medicine produces problems in the patient-physician relationship (Beck, 2004). In current times, the management of patient-physician relationships is becoming increasingly challenging. First, due to the COVID-19 pandemic, the interaction between doctors and patients has increased, which creates more chances of misunderstandings and disputes. Due to the scarcity of medical resources, medical-related suit surges (World Health Organization, 2020). Second, the internet has brought a new information source to patients (Kilbride and Joffe, 2018). Diseases are a thing that everyone wants to keep away from. After diagnosis, a patient and their family members feel fear, and they may seek any alternative information sources and try to be their own doctors. However, such information may be unverified, and sometimes it can be misleading, but patients have difficulty distinguishing it from professional advice, leading to a lack of trust in doctors’ decisions. Third, coverage of doctor-patient disputes on social media makes these events a public focus, potentially exacerbating the conflict between doctors and patients. Therefore, efficient and effective communication between doctors and patients has become crucial for overcoming these new forces that can undermine patient-physician relationships. The current chapter explains how VR, often used to demonstrate complex concepts, can play a unique role in enhancing doctor-patient communication in medicine.