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Redefining the Doctor-Patient Relationship


The days of the doctor knows everything are over. Physicians must work hand in hand with patients to improve outcomes.

The days of paternalistic (or maternalistic as the case may be) medicine no longer exist. Doctors acting as parent figures telling their patients what is best for them does not work in the 21st century.

Yet, many doctors and patients are forgetting to evolve into the modern world. Doctors send off the prescriptions and orders while patients are left to wonder why. And patients fail to know the names of their medication and just refer to it as "the little white pill."

With the internet available at everyone's fingertips, patients have the ability to be more knowledgeable users of the healthcare system. And doctors should encourage this pursuit. The doctor-patient relationship should be more a united team effort. Both parties need to become more educated and better communicators.

How can we redefine the doctor-patient relationship?

- Doctors need to understand that patients are researching their medical conditions outside the exam room. We should encourage patients to own their disease, as it can lead to better outcomes. They will understand why they were prescribed the medications they were and will actually take them.

- Doctors should direct patients to resources that provide accurate information. There is a lot of bad information out there. There are many selling products with no real evidence they work, yet they convince people to purchase them. We should try to protect our patients from these gimmicks.

- Patients need to become empowered and understand their diseases and medications. They must take an active role in the decisions made about their own health. They need to ask questions. In the past, one of my patients has returned from a specialist without knowing what the specialist was thinking. I asked why they didn't ask the specialist and they tell me they were afraid to ask.

- Doctors must present their patients with choices and make a shared decision with them. Yes, we can tell them what we think is the best option. But, ultimately, the patient is the one making the decision.

- Doctors must become educators. It is imperative our patients understand their medical problems and why they are taking certain medications.

- Discussions need to happen in the exam room: not just a litany of symptoms with a resultant prescription of a medication. Many times I see patients come back from a specialist with no idea what was diagnosed or why they are taking a medication.

- More listening needs to happen on both sides. Doctors are constantly critiqued for not listening to patients, which may be true in many cases. Often, patients don't listen either. Many times, doctors tell a patient something and it goes completely unheard.

Practicing medicine is becoming more difficult than ever before. Technology and innovation strikes out from all corners of the medical stratosphere and we run to keep up. Data becomes more quantifiable and we are regulated to follow new guidelines. Our time is being constricted, while more and more is expected from healthcare providers. We struggle to give our patients the time they need, but there are only so many hours in a day.

Patients, as well, are being bombarded with medical news being poured onto them. They struggle to know what is real and what is not. They are living longer, yet have more complex disease states. While outside forces chip at doctors' time, patients need that time in greater and greater increments.

To keep up with the advance of medicine, both parties need to redefine how they interact with each other.  Until then, optimal clinical outcomes will remain out of reach. Isn't it time to redefine the doctor-patient relationship?

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