Physicians should go back to basics with their patients

Commentary. By Eric Anderson, MD, AMNews contributor. Oct. 7, 2002.

COMMENTARY

Observations on the state of medical practice and medical life

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At a time when there's never been more known about health and disease, Americans have never seemed more confused about what they want from their doctors. It's a bit like the anomaly of what people expect from their politicians: more services but less taxes.

Although we find bumper stickers that say, "I love my country; it's my government I hate," we don't quite get that love-hate connection with our patients. But in my opinion, the doctor-patient nurturing relationship, developed over the centuries, is basically gone.

Oh, there are surely small towns in Iowa, coastal villages in Maine and remote settlements in Texas -- and elsewhere -- where doctors still bleed for their patients, but in general, in this new century we've practically bled out. It's a shame we've lost what was always so precious to the sick: caring, compassionate, personal physicians who knew their patients well and were full of the milk of human kindness. That the milk would appear to have gone sour is only partly the doctor's fault; there are two persons connected to a stethoscope, one at each end.

For our part, we permitted the insurance companies to intrude into what is essentially a very private relationship and, surprisingly for a group considered to be so entrepreneurial, we rolled over when managed care became the New Deal. And we allowed, even caused, medical care to become a business. Big business.

But I blame our patients more, only partly because, like many people, I don't always care to look in mirrors. I blame patients because they are so ready these days to believe the worst of us collectively. Maybe they are that way because they are bombarded by the media. They read magazines that exhort them to take charge at the doctor's office, or articles that tell how to haggle with doctors over fees. [...]