THE DOCTOR AND INTERPROFESSIONAL RELATIONSHIPS
Doctors work closely with nurses, pharmacists, social workers, physiotherapists and many other professionals in delivering health care. The quality of this care is enhanced if in the working relationship there is good communication, mutual respect and a proper understanding of the roles, responsibilities, capabilities, constraints and ethical codes of the various professions. Little formal attention has been paid to the importance of these interprofessional relationships in the undergraduate medical curriculum or in postgraduate medical training. All health professionals along with doctors share similar ideals, being concerned with helping people prevent or overcome illness, with relieving suffering and maintaining life of good quality. They generally share similar ethical codes, being bound to maintain patient confidentiality, to respect patients, to be honest and to show integrity. Most health professionals are subject to legal constraint through a registration process, with disciplinary mechanisms for professional misconduct, and mechanisms to deal with those whose health is impaired to the extent that the public is at risk. Some of the legislation also places limits on the scope of practice of the health care professional.
In hospitals the key interprofessional relationship for doctors is the one with nurses. Changes to nursing education, the scope and organisation of nursing practice and nursing philosophy have led to a change in the balance of this relationship during the past 20 years.1234 This chapter summarises the professional roles of nurses and other health care workers in patient care and discusses ways to enhance interprofessional relationships. It also provides guidance on the relationships which are expected between doctors and lawyers and others who act on behalf of patients and brings attention to the importance of the spiritual dimension in the care of many patients.