NewYorkTimes Tara Parker-Pope's piece this week hit the nail on the head. The doctor-patient relationship is in trouble...big trouble!
Parker-Pope has a way of accurately encapsulating today's health issues and this issue is no different. Since this is a relationship I know well, I was impressed how accurately she described it - the good, the bad, and the ugly.
I've had many wonderful moments with families but there have been many times I leave a room scratching my head, wondering what I could have done to have helped that family feel more at ease. While I admit there are times I could have phrased something better or been more tactful, there are even more times when all my best efforts don't seem enough. Those are the times that worry me.
My list of why the doctor-patient relationship is in trouble is similar to Parker-Pope's list. In my mind, the major reasons for the decline include, in no particular order:
1. physician dissatisfaction with clinical life
2. physician dissatisfaction with income
3. unreasonable or unfair patient or family expectations
4. "Dr. Google"
5. A decline in the respect given to experts for their education and training
6. A health care system that doesn't allow enough time for good communication
7. People not following advice given without consulting their doctor first then calling to complain they are not better
8. People not understanding that pills and antibiotics are not the cure for most things
9. People not understanding that tests are not the path to most diagnoses
10. People not taking ownership for their own health day to day
One of the doctors interviewed by Parker-Pope described a typical health care encounter almost like a face-off. Great analogy! That is just what it feels like much of the time - but it doesn't have to be that way.
To turn this mess around, we all have to do our part in the system to de-escalate the relationship. Since this is a relationship, everyone has to accept responsibility for what they bring into the room and work on their part of the friction. So, while us docs are working on communication and better listening, patients and families have some work to do, too. They need to cut us some slack and understand we are only human. And, a little respect would go a long way. It is so difficult to try and help someone when they sort of cop an attitude because of something found in a Google search. As I've mentioned in prior posts, reading a medical lithograph and interpreting it are very different. there's a reason we have 4 years of medical school and 3+years of residency training. If people want us to respect their questions and fears, which we all try to do, our expertise has to be respected, too.
As for the medical system, that is broken and needs to be fixed. It is destroying morale and the work environment actually driving doctors from clinical medicine more often than most people want to discuss. We are not being greedy to want to be paid fairly for our time given how many hours a week a logged in caring for people. And, it is not greedy to want to have a family life and some personal time, either. There has to be a way to pay doctors fairly while structuring a work environment that is supportive and recognizes that we all have lives outside of medicine.
The good news is that we are finally having a conversation about this very difficult and important topic. That's the first step to finding a solution and improving the satisfaction on both sides of this face off. If we work at it and succeed, we'll find ourselves still facing off - but on the same side of the puck with both of us against the medical problem. That's the way it used to be, and the way it needs to be again.
Posted by DrGwenn
Parker-Pope has a way of accurately encapsulating today's health issues and this issue is no different. Since this is a relationship I know well, I was impressed how accurately she described it - the good, the bad, and the ugly.
I've had many wonderful moments with families but there have been many times I leave a room scratching my head, wondering what I could have done to have helped that family feel more at ease. While I admit there are times I could have phrased something better or been more tactful, there are even more times when all my best efforts don't seem enough. Those are the times that worry me.
My list of why the doctor-patient relationship is in trouble is similar to Parker-Pope's list. In my mind, the major reasons for the decline include, in no particular order:
1. physician dissatisfaction with clinical life
2. physician dissatisfaction with income
3. unreasonable or unfair patient or family expectations
4. "Dr. Google"
5. A decline in the respect given to experts for their education and training
6. A health care system that doesn't allow enough time for good communication
7. People not following advice given without consulting their doctor first then calling to complain they are not better
8. People not understanding that pills and antibiotics are not the cure for most things
9. People not understanding that tests are not the path to most diagnoses
10. People not taking ownership for their own health day to day
One of the doctors interviewed by Parker-Pope described a typical health care encounter almost like a face-off. Great analogy! That is just what it feels like much of the time - but it doesn't have to be that way.
To turn this mess around, we all have to do our part in the system to de-escalate the relationship. Since this is a relationship, everyone has to accept responsibility for what they bring into the room and work on their part of the friction. So, while us docs are working on communication and better listening, patients and families have some work to do, too. They need to cut us some slack and understand we are only human. And, a little respect would go a long way. It is so difficult to try and help someone when they sort of cop an attitude because of something found in a Google search. As I've mentioned in prior posts, reading a medical lithograph and interpreting it are very different. there's a reason we have 4 years of medical school and 3+years of residency training. If people want us to respect their questions and fears, which we all try to do, our expertise has to be respected, too.
As for the medical system, that is broken and needs to be fixed. It is destroying morale and the work environment actually driving doctors from clinical medicine more often than most people want to discuss. We are not being greedy to want to be paid fairly for our time given how many hours a week a logged in caring for people. And, it is not greedy to want to have a family life and some personal time, either. There has to be a way to pay doctors fairly while structuring a work environment that is supportive and recognizes that we all have lives outside of medicine.
The good news is that we are finally having a conversation about this very difficult and important topic. That's the first step to finding a solution and improving the satisfaction on both sides of this face off. If we work at it and succeed, we'll find ourselves still facing off - but on the same side of the puck with both of us against the medical problem. That's the way it used to be, and the way it needs to be again.
Posted by DrGwenn
2 comments:
like i always believe it all narrows down to GOOD COMMUNICATION in every visit in every patient. Only GP's do that well***
I agree. But any one can do this. communication is some thing that can be learned.
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