Are doctors and patients heading for divorce court? 

Something has gone terribly wrong in our medical system.  The doctor-patient relationship, the keystone of medical care, has soured, and both the quality and spirit of medicine has been tainted.

Remember Marcus Welby?  He genuinely enjoyed his patients and they showered him with love and cookies.  There was warmth and trust and mutual respect permeating his office.  That was the model that I, and many of my fellow medical students, kept in our minds as we endured hellish nights on call and humiliating grilling by our superiors.  Once our grueling training was over, we imagined, we would bask in our patients’ admiration and gratitude as we healed the sick and comforted the dying.

I know… we were melodramatic and grandiose.  But we meant it.

In the 15 years since my med school graduation, I have noticed an increasing and disturbing disconnect between patients and doctors.  I notice it in my own patient encounters, I hear it in the grumbling of my peers, and I read it in heated internet discussion boards and blogs.  Check out a recent example from the NY Times.

Here are the basic issues as I understand them:
•    Patients think that doctors are insensitive and arrogant and they don’t like being rushed out of the office.  Some feel that doctors are disrespectful of their patients’ time and that they don’t welcome patient participation in treatment decisions.  Others feel that doctors are whiny and privileged and should just stop complaining.
•    Doctors tend to think that patients are ungrateful and hard to please.  They get offended when patients challenge their medical diagnosis or recommendations with an internet printout.  They may feel that their extensive education and sleepless nights caring for patients are discounted in favor of unproven or inappropriate treatments suggested by non-medical sources.  In addition, they are often mistrustful of patients and worry about being sued despite doing their best to practice good medicine.

Whose gripe is accurate?  Both of them, of course.  Both parties have legitimate concerns but they seem to be locked into their respective corners of the boxing ring.  We must bring them back toward the center.  But how?

I am very interested in your opinions.  For those of you who see yourselves in either of the above scenarios, what do you think we, doctors and patients, can do to heal the broken doctor-patient relationship?

Communication is crucial for healing any fractured relationship.  Let’s start now. 

Warmly,

Dr. C.
www.insightmedicalconsultants.com
(photo courtesy of ruralresidency.com)