Like all good professionals, doctors have also changed with times. In the good old days, a general practitioner [GP] was extremely personal with his advice sought on every family issue. Many modern doctors are business-like, some with alleged commercial association with pathology labs. We are not comfortable with this change. We wouldn’t consult a doctor who does not meet our image of a him, , . We don’t like to see doctors with punk haircuts; we wouldn’t consult a doctor with a pierced tongue. For centuries, we have bound them in our ideas of them and in our expectations that arise out of our need to feel reassured in difficult times. We are willing to forgive every failure of everyone else, but doctors can never have this luxury.
If there’s one profession in this world that is put on a pedestal and is also pulled down as quickly, then it is medicine. Doctors are expected to make things all right, come what may. If they do, they are divine; if not, God save them!
We want to trust them but, strangely, won’t. We laugh at the jokes like “Doctors are the same as lawyers; the only difference is that lawyers merely rob you, whereas doctors rob you and kill you too.” “Why do surgeons wear masks during the surgeries? Because if anything goes wrong, no one will know who did it.” We watch horror flicks with morbid fascination where the doctors do the unthinkable on the operating table; we see them in classics like Citadel struggling against the establishment or read them in best-sellers like Coma and are convinced of their heroism.
Doctors are powerful, doctors are appealing. There’s a halo around their heads as they decide our fate using medical terminologies that we do not understand. We trust them and surrender to them. We only surrender to those whom we place our faith in; to those whom we put high above us. And when these man-made Gods make human errors, we curse them or even attack them physically. We have heard of doctors being assaulted by the patients’ families, their clinics burnt and their lives threatened. There is a rise in the medical lawsuits with doctors becoming wary of litigations or and the associated compensations they may have to pay.
What could have made us go to the other extreme after centuries of deference?
The rise of health consumerism has been changing the traditional light in which we have been seeing doctors. It has also encouraged a contractual and conflict-generating relationship with them. An increasingly well-educated population has started challenging medical authority, and now treats the doctor-patient relationship as yet another provider-consumer association, rather than a sacred trust filled with awe and reverence. With the many alternative healing methods available, there is a dramatic rise in the number of doctors who could provide you with a second opinion. A few bad apples and a couple of experiences of indifference and greed have also goaded patients to distrust physicians. The lowered quality of health in congested cities, the rising stress and lowered tolerance, has added to people reacting strongly to what sometimes are human errors made by doctors as human beings or issues which are beyond their control.
The Guidance-Cooperation Model
To avoid the two extremes that we reach in our dealings with doctors, we – as patients – need to change. Today, a conscious “Guidance-Cooperation model” of a doctor-patient relationship seems like a better option. The doctor is supportive and non-authoritarian when he/she recommends a treatment, yet is responsible for choosing the appropriate treatment for the patient. It is up to us, patients, to accept or reject it. However, for this to work, we need to get pro-active, ask questions and understand the pros and cons, the benefits and the dangers involved in a treatment. We need to convince the doctor that we like to have them talk to us in an egalitarian way, listen, ask a lot of questions, and explain things in a simple way. When that happens, the privilege of medical knowledge of the doctors will no longer make them seem superhuman. Both of us – patient and the doctor – will be equal participants in our process of healing.
Researchers have found that such a concrete communication can also have an effect on the clinical outcome of the treatment. When we as patients are satisfied with this connection with the doctor, it also tends to alleviate psychosomatic symptoms, if any. It makes us more compliant with our treatment regimes. This obviously results in a better outcome. The doctors, at their end, can understand that encouraging an active rather than a passive role of the patients does not mean de-professionalisation of medical practice. The more comfortable people are with them, the lesser the social distance and better the cooperation between the two parties. In any process of healing, trust and communication matter as much as the medication.
Agreed that medicine is fundamentally a vocation to help man under stress and not to exploit his need but, at the same time, it is also a profession. We need to look at it realistically and at the practitioners of it, sensibly. The doctor is as human as anyone of us and it is only human to err. A doctor does not have a halo or wings. But then he also doesn’t have a tail or a pair of horns. It’s time we stopped looking for either.