Some of you who read these essays may wonder why I place this symbol, a bidirectional arrow, between the words doctor and patient, when I write the phrase, doctor patient relationship. If you can remember high school chemistry, it is the symbol for equilibrium reactions. And this is how I view the doctor patient relationship, as an equilibrium of trust between two people. The symbol tells us that the relationship is a two way street allowing the mutual exchange of information, the mutual development of trust, and the delivery of and receipt of medical care. The figure shows the interplay of what I think are prerequisite characteristics of doctors and patients for the development of successful relationships through which good-quality medical care can occur. It is also figure 3 in my book, Equal Health Care For All, published in 2007.
I had received some suggestions for this figure when I was writing Equal Health Care For All. One person suggested that honesty be added to the figure. I believe that I would be on firm ground if I added honesty to both columns. But because I think honesty has to, by definition, permeate an entity called a mutual trust I didn’t write it out. Another person suggested that warmth should be added to the doctor column. Again, I didn’t write this out specifically because it seems to me that if the doctor brings those listed characteristics into play that must mean there is some measure of real underlying warmth.
I am sure other people can come up with a figure or diagram and a list of attributes equal to or even better than my list. The important part of this would be that they are actually thinking about it. Give it a try. Figure out what you want from your doctors and your patients and what you must bring in your effort to develop sound, ongoing, non-conflicted doctor patient relationships.
The statement which this figure does not make and which seems obvious to me and, I think, to most patients is that this relationship is SACROSANCT, not to be trespassed upon by anyone. A major problem in America is that people, whose careers happen in the business of medicine and in politics, do not seem to understand this. Whether they truly do not comprehend the effect of their machinations for increasing profit and for garnering votes, financial campaign contributions, and other favors on the the non-conflicted functioning of the doctor patient relationship or have decided that this relationship is a tool for them to achieve their goals is not clear to me. Maybe it’s a combination of both in this arena. But I tell you that if it doesn’t stop, there can be no true healthcare reform because health care ceases to be the objective of that reform.
I suggest that you read a couple of other recent articles about this. I provide the links below. Read these pieces carefully and think about them. It’s your healthcare system, and you pay for it completely regardless of what type of 3rd party payer administers payment of the bill.
- ObamaCare’s Lost Tribe: Doctors by Daniel Henninger in the Wall Street Journal. http://online.wsj.com/article/SB10001424052702304708604577505210356532588.html
- Playing Politics with the Doctor—Patient Relationship by Deborah J. Oyer, MD in the New England Journal of Medicine http://www.nejm.org/doi/full/10.1056/NEJMc1205009 Here, it’s also worth the time to investigate the two references for their information. Just click on references and links are provided.