Doctor/Patient Relationships: Who is Responsible

By Karin Krisher

This blog post around, a strong opinion is just what the doctor ordered. The idea of the doctor ordering anything is the topic behind my not-so-subtle opinion. General perceptions/interpretations of a well-written article about doctor/patient relationships– and the conversation surrounding it– have me steamed. And here’s why:

It’s easy to point out the obvious, which is that doctors can act in an authoritarian rather than an authoritative manner that doesn’t allow their patients to feel comfortable having an honest conversation. Of course, this statement is general—and neither the fact of this possibility nor the ease of pointing it out is my criticism of the article.  In fact, the article itself does a lot in the way of exploration.

Here’s my real problem. The article lends itself to a misinterpretation that renders the resulting conversation moot. Most commenters make some sort of sweeping statement about how they agree that the whole system of doctorhood should change. Some make suggestions about what current practitioners can do to ease their patients into conversation.

Teaching the Doctor/Patient Relationship

But few comments, if any, suggest what they as patients can do—and even fewer make statements about how our educational system can make this change before seeking out medical advice on one’s own is even a concern.

My mind immediately flashed to my high school health class, which sufficiently outlined the dangers of drug use and unprotected sex. Completely absent, though, was any mention of general healthcare and the overwhelming responsibility of taking it into one’s own hands.

How? Isn’t learning to communicate with healthcare professionals and solidifying the doctor/patient relationship part of continuing health? Isn’t that facet of health as, if not more, important than an oft-repeated and wildly authoritarian summary of normal teenage risks?

What if the discussion of health as a continuing process became a standard of public education?  Similarly, what if communication classes and a basis in psychology became a standard for medical education programs? Judging from the comments of an educated population on such a well-researched article, this concept really has been so long ignored that we now have only one option: give authority to those that we are saying have too much of authoritarian attitude to fix something broken.

The sheer scope of suggestions about how to fix the system clearly tells us that creating something functional in the first place isn’t on the public’s radar. But it’s in my nature to trace something to its roots, and mine run deep in a public education system that grossly ignores the power of learning how to communicate effectively.

Educating students about communication strategies in public school health classes should not simply be relegated to a one hour session about how important it is to say no to peer pressure. Educating medical students about communication strategies shouldn’t be relegated to a few weak examples of how one will feel the first time they must give an unfortunate diagnosis. We need to dig deeper.

What about teaching the value of general openness and how to achieve it? What about placing that responsibility on both ends, giving both the question asker and the responder the power to effect an open relationship? Currently, we’re stuck asking for less authority and at the same time demanding more. And I use the word stuck for a reason.

Let’s move forward, together. If you are someone who has the power to discuss health education in any sort of forum, do so. And tell us about your efforts in a comment.