Doctor Patient Relationship

An individual professionally trained to treat an ill and suffering person (patient) is a doctor. And their natural relationship is a bilateral one.

When a doctor is sincere, focused, patient, persistent with ethical conduct, a continuous learner, and doing keen observation – it is certain that doctor–patient relationship is the most enduring and satisfying relationship where the doctor learns to hear and see with heart and mind. This healthy and strong relationship will survive forever. (A)

Doctors and patients are the two sides of the same coin fighting their common enemy: disease. In fact, medicine is not a mere profession, it is a calling, a mission, or perhaps even devotion. (C)

During sickness, the patient and his entire family look up to only one person after God and that is the doctor. In the old days, when doctors relied more on their clinical skills than on investigation, patients trusted them with full faith. In those old days doctor was a healthcare giver, philosopher, guide, and teacher – a member of the family while considering this complicated doctor–patient relationship we will have to consider the factors related to their relationship.

Machines: Modern-day medical practice is full of technology bringing modern machines – diagnosing the disease with pathological, radiological, and other aids. They are meant to augment Doctor’s ability to diagnose and not replace them totally. The “S” singularity of machines tries to replace a doctor but that is not possible. (E)

The corporatization of medical treatment has given all the seriousness under one roof with all the modern medical instruments and highly trained doctors. But sadly it took away the human touch. Compassion became a victim of greed on one side (doctor) and unfulfillable demands of the patient on the other. Ultimately strange bitterness invaded the holy patient-doctor duo. (F)

Media: Print, electronic and social media also played a hoax. In hunger for sensationalization and increasing viewership, the media failed to paint the true picture: “especially from the doctor’s point of view” leading to doubt and low regard for the humble profession of doctors. (G)

Google: Huge influence of knowledge given via youtube – Wikipedia – WhatsApp group – made patients think, “they know everything”. They understand the disease and treatment. In fact, details on Google are neither right nor authentic. Patients trust all they read there, putting doctors on backfoot. (H)
Doctors are not God, but merely an instrument of God. Not everyone can and will be cured. (I)
Complications are bound to happen in the best of hands with almost care. Doctors should seek another colleague's opinion to seek support and involve as many other doctors as possible.

Mob Violence: Unending patients’, expectations and politically supported gangs who exploit doctors lead to mob violence. Arrogant, ill-behaved, and threatening relatives do violence leading to physical assault on doctors, damaging hospital premises, and destroying precious instruments. Though few patients are troublemakers, all are not. They make doctors monsters from demigods. Mob violence makes doctors feel timed, gutless, and easily terrified. Doctors become zero from heroes. 75% of doctors in India have faced violence once or more times. (Y)

Medicine is not mathematics and so no single formula can be applied to one and all. Every patient is different and multiple factors play a role in the end result. But without understanding all these details, a judge with little knowledge of medicine and overcharging exploiting lawyers decides the amount of compensation. With the fear of this law, doctors give defensive treatment, advise detailed investigation and refer the patient to a higher center for treatment.

So, present day, three requirements are medically trained judges, legal media restrictions, and appropriate remuneration to doctors.

The remuneration of doctors is always expected to be low telling it to be the profession of human service. Everyone expects discounts when it comes to the payment for health. Medicine is a noble profession, but it is still a business and so doctors need to be paid fairly for their talent. This expectation of low charges, generous, and charity doers can not be satisfied, because expenses for medical education, hospital premises & staff salaries, modern-day costly instruments, and government taxes demand a big amount of money.

The life of a doctor is worth studying before discussing anything. Doctors never refuse a call from the patient. Sleep deprivation and stress are the killing factors leading to five to six years less life for a doctor than the general public. All are allowed to fail, but doctors do not have that luxury. When complications arise, doctors become sleepless, tense, stressed, and has the feeling of anger, shame, and humiliation. Remember, doctors, too, are human and doctors too are only human. Doctors miss numerous family dinners, birthdays, marriage and even visiting their dying relations. They have no family life and sometimes face failed marital relations leading to divorce. Female doctors have more problems because they have to look after domestic work settings, husbands- children, elderly, and sometimes they have to cook in addition to days work of medical practice.

So medicine is an art of healing. Doctors can cure the patient with empathy, meaningful conversation, and sometimes with just a reassuring smile. If a doctor can communicate effectively with the patient and his family and take time to explain the disease, its prognoses, limitations of the doctor himself, and probable charges of the bill, the patients are ready to accept even the most.

Black sheep: However for every failing guilty doctor, thousands are honest, treat countless patients tirelessly and make their life better.

Similarly, for every inconsiderate patient, thousands are grateful and make the doctor's life journey worthwhile.

Corruption and greediness are related to society in general and are reflected in both doctors and patients.

I will summarise the long story short telling a few more things.

Healing touch: Some doctors have a healing touch that works wonders and transforms the patient’s life.

Faith: 100% faith is a must. 1% fear with faith means fraud! Faith infuses positive thoughts, expectations, and communication in the patient.

Law of attraction: Here one says that you can attract whatever you wish.

Law of acceptance: Death is inevitable. Doctors can only do their best to postpone it. Doctors can treat, but can not decide the outcome (end result).

Be non-judgemental: Sometimes there is an end of life. It is time for people to go and they do. The doctor must never feel that he can confer immortality to any patient.

Spirituality is an individual's search for the ultimate meaning of life mixed with humanism, rationalism, and naturalism. It plays a major role in healing. Spiritual dimension showing prayer with great faith in God, chanting mantras repeatedly and meditation do have a great role in healing. Cultivating optimism and positive emotions can counter depression and make healing faster.

Ralph Waldo Emerson said:
The purpose of life is not to be happy, it is to be useful, to be compassionate, and to make some difference that “you have lived and lived well.”
Take home message:
Despite longanimity of life, eradication of many diseases by vaccines and cure by transplanting vital organs, nobody is going to live a healthy life forever. So doctor’s help in curing physical illness is a must and doctors have voluntarily chosen to be a healer by profession. Thus doctor – patients relationship is compulsory.
Present-day society: “full of stress, hurry, corruption, infighting and having suspicion all around” has to be accepted as a reality. Few of the doctors and patients may not be honest and well behaved respectively. Both have to rationalize the relationship. Patients should find out a reasonably clever – honest and compassionate doctor around. Afterward, the patient should trust the doctor, have full faith, and tell him the details of illness and addictions. Doctors should be cautious regarding treatment, charges, and their own safety against violence.

Dear People, with Love and Care, Your Doctors
  • Book Title: Dear People, with Love and Care, Your Doctors: Heartfelt Stories about Doctor-Patient Relationship
  • Author: Debraj Shome and Aparna Govil Bhaskar
  • Book Review: by Dr. Bharat Desai, Date: 07-Dec-2022
  • Price: ₹ 389
  • Pages: 298+22
  • Publisher: Bloomsbury, New Delhi (2019)

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