Doctor-patient relationship: between desire and possibility in primary health care

The doctor-patient relationship in the context of primary health care challenges the implementation of humanized health practices, considering their relevance and the emergence of humanization as a social need. In order to advance in this field, it is necessary to review what has been produced on this issue, mapping the boundaries and advances of this relationship. This study seeks to understand this relationship as part of primary health care practices, thinking the doctor-patient relationship in hermeneutic terms, from the construction of new horizons in terms of normative ethical and moral values in order to obtain a more humanized health. The study was conducted from 2008-2009 in two family health units in the city of Fortaleza, state of Ceará. Techniques of in-depth interview and participant observation were applied, totaling 11 interviews with doctors and 37 with patients, in addition to the recording of 53 consultancies. Data were organized and analyzed using the software NVivo Qualitative Solutions Research (QSR). Patients and doctors reflected about three main aspects that influence the clinical interaction in the Family Health Strategy, which are: personal characteristics of the physician, professional acting and problems in the services organization. Among the results, three profiles of the physician-patient encounter emerge: the patient-centered encounter, the consultations "without understanding" and the short-term encounter. Establishing a relationship requires intensive support to change services organization, emphasizing training that values culture, leadership and philosophical reflection of human society, aiming at the qualification of primary care.

Primary Health Care; humanization of care; physician-patient relations