Awaiting demands of tomorrow's patients

Commentary. By Eric Anderson, MD, AMNews contributor. Aug. 13, 2001.

COMMENTARY

Observations on the state of medical practice and medical life

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When I was a solo country doctor in Texas in the early 1960s, my house-call area was greater than the state of New Hampshire, my small town had no hospital and the nearest emergency room -- and I do mean room, not department -- was 37 miles away.

Life was easy. I had the patients of the '60s. Yesterday's patients.

Tomorrow's patients are going to be different. We're seeing this already.

Today's patients are better informed and more medically sophisticated, desirable traits in those who will be our partners in health care. But they are also more demanding and more querulous, less endearing qualities to those who will be their professional attendants and who, in contrast to their patients, did go to medical school. Tomorrow it will be more of the same and then some. The challenges will center around specific issues, some old, some new and some insoluble.

In the '50s, when I was a medical student in Edinburgh, our patients were medically unsophisticated. Classic was the story passed down about Sir Halliday Croom, a former professor of obstetrics who had just had a patient referred him by a colleague.

"Did he examine you?" Sir Halliday asked.

"Yes, indeed; he made a digitalis examination."

"Ah," said Sir Halliday, "then I trust he wore foxgloves."

Tomorrow's patients would be laughing before the professor. Not only do our patients know better what happened to them in the past but they know exactly what they want in their future. Some of them have heard even before their doctors that statins not only lower cholesterol but also reduce C-reactive protein and may prevent MIs in patients with normal cholesterol. And guess what that makes patients want? [...]