Doctors play a very important role in our lives and enjoy a very high position in our society. We respect them, and depending on the outcome of our treatment with them, even revere them. But often, our understanding and our expectations are like a one-way street. We are so self-absorbed with our own health preoccupations and anticipations, that we rarely, if ever, consider that doctors too might expect something from us. So we called upon two doctors—a paediatrician and a clinical psychologist—to share their side of the story. We wanted to give you complete picture from the physical and physiological medicine professional’s point of view and from a mind doctor’s as well.
Here’s what they told us:
Dr P V Vaidyanathan, paediatrician, Mumbai
It is humorously said about doctors that a doctor is God when a serious patient is brought for treatment, a great human being as the patient is recovering and a devil when he presents the patient with a whopping bill. Within a span of a few days, it is interesting to see how the same person goes from being a God to a devil. And this example really portrays the position or status that a doctor enjoys in our society.
Old was gold
Over the years, the public’s image of doctors has undergone a sea change. Fifty or sixty years ago, no patient would have ever dreamt of doubting a doctor’s abilities, motives or competence. No patient would have sued a doctor, let alone vandalise his hospital or dispensary with the help of an angry mob. Patients rarely went ‘doctor shopping’ or ‘hospital shopping’ as they do today. Neither would they choose a doctor or hospital based on their medical insurance.
Fifty or sixty years ago, doctors too would not have persuaded the government to pass a law to make aggression against them a non-bailable offence. But as with all other things, life changes, perspectives change, and nothing remains sacrosanct or supreme, not even a doctor.
Today, life is different [and perhaps difficult] whether you are a patient or a doctor. Both our expectations have changed.
What you expect from doctors
Patients’ expectations from doctors are quite simple and straightforward—the doctor should be smart, communicative and presentable. S/he should be honest and sincere, should treat patients with respect, sensitivity, sympathy and love. Doctors should be accessible and approachable at all times, answer patients’ phone calls and address queries. A doctor’s treatments should be effective within the shortest possible time, and his or her charges should be reasonable.
Most patients also expect their doctors to be respectable and responsible citizens, and would definitely be unhappy to see their doctors behaving badly in public places, dancing on the roads or partying in pubs. Beyond this, there is nothing more that a patient wants from his or her doctors, although this list of wants itself is something, which most doctors find it impossible to live up to.
What doctors expect from you
This set of expectations is more difficult to define, because patients all over behave as a group, while each doctor is more an individual, when it comes to expectations or preferences.
It also depends on what a doctor is looking for in his medical practice, which depends on the motivation behind becoming a doctor. Some become doctors with the intention of serving mankind hence their expectations are different from the rest. Some others become doctors to continue family heritage. Still others get enamoured by the glamour associated with the white coat, and with the so-called [apparent, not real] authority attached to it. Finally, there are those who are in it to make lots of money. So motivations differ, so do expectations.
By and large, most doctors desire a huge practice in the initial years and are willing to stretch to any extent to build up their clientele. After working so hard to acquire this, they then crave more free time and relaxation. This, unfortunately, is the paradox of a doctor’s life. Most doctors who are about ten years or more in practice are often in this situation. And it is often at the core of how doctors behave, vis-a-vis their patients. Apart from each one’s innate personality, it is this situation that makes doctors feel frustrated, short-tempered, irritable, angry, and sometimes downright nasty. In a way, doctors are also actors; those who are better actors can conceal these true feelings from their patients. Those who are not, land up mistreating their patients.
Nevertheless, there are some things that most doctors agree upon, and would want their patients to do. Whether their patients fulfil these expectations is another matter altogether. Doctors would like if patients:
- Are punctual for their appointment and call to cancel it if they are unable to come.
- Introduce themselves when first they call doctors on the phone, before launching into their problems, which happens very often. Usually, the doctor has no clue who the patient is and often needs to ask the patient his or his name, last visit and treatment details. Patients expect their doctor to know their problems and medications by heart, which is often not the case.
- Keep a pen and paper close by when they call their doctor to note down the doctor’s prescription or advice. Often, patients put the doctors on hold, while they go hunting for a paper and pen. And nothing irritates a doctor more.
- Avoid lingering in the doctor’s consulting room discussing this or that after the consultation. Especially if the waiting room is full, making other patients wait unnecessarily. Many times patients fail to read the cues the doctor gives and carry on talking.
- Go over for personal consultation rather than expect the doctor to make diagnosis on phone on the basis of some symptoms. “Doctor, my child has fever from yesterday. Do you think it could be Malaria or Typhoid”? Your doctor is a scientific person, not an astrologer or magician. It’s not always possible for him/her to give you a diagnosis on the phone without a proper check-up.
- Listen carefully to the doctor when s/he is giving advice before cross questioning, or cutting him or her off. Some patients keep on asking questions but rarely seem to listen to what their doctor is saying. They then forget half the things when they go home and then call to ask again. This is an avoidable trait.
- Do not bring in too many people inside the consulting room. Many a times, four or five relatives accompany one patient, all of whom insist on participating in the discussion. A doctor gets both irritated and intimidated, on seeing a large crowd entering the room. It is always better that only one or two people accompany the patient into the doctor’s chamber, while the others wait outside.
- Stop visiting the doctor every day, if not required. Sometimes even when the doctor assures their episode will last for five or seven days, they keep coming back. This puts pressure on the doctor to do something different, and he often lands up prescribing tests or medicines that may not be strictly necessary. But there is also the possibility that if he does not, these dissatisfied patients might go to some other doctor. So, he is often in a no-win situation.
- Refrain from disturbing their doctors at odd hours or on holidays, unless the matter is really serious.
- Call up the reception and not the doctor’s mobile phone to enquire about his or her availability and appointments. Your doctor may be driving, or with a serious patient, or might even be in the operation theatre. It is always safest to call him on his landline.
These are expectations some patients fulfil and some don’t. And humans being what they are, there will continue to be both type of patients as there will be doctors whom patients love and whom they don’t. A doctor-patient relationship is unlike the other relationships we form in life, and it is often difficult to keep both parties satisfied and content. The least both the doctor and the patient should aim for is to make life easier for the other.
Dr Sukanya Ray, practising clinical psychologist, Bhopal
I think people need to change their outlook towards psychology and its practices, and clients need to think more clearly about why they might want to seek help from a clinical psychologist.
The solution lies in creating public awareness and imparting education about these issues.
There are many things that those seeking psychotherapy need to understand and accept so that their treatment will be a much more enjoyable process both for them and the therapist. These are:
- The biggest misconception I have to fight while dealing with my clients, is that I am a ‘mind-reader’ and that I have the solution to their problems ready. Clients often come to the clinic with their preconceptions about psychology, especially about psychotherapy [most of which are gathered from pop psychology books, malpractices or the internet] and this bias prevents them from learning the work that is actually done.
- Sometimes, people confuse psychotherapy with counselling, and some parents or caregivers think my job is to pass messages from them to the client.
- Some people harbour disrespect for psychology as a science, and therefore, have little faith in psychotherapy. They also start discussing these beliefs at the actual consultation, or go on with the process of therapy with an undercurrent of distrust and doubt about the therapist.
- In couples’ therapy, couples may not be ready for change, or may come to seek therapy as a last option before signing the divorce papers. In such a scenario, if therapy fails, clients often blame the therapist or the science of psychotherapy.
- When people come to the clinic with their problems, I explain to them that the solution does not lie with me, and the onus of change is largely on them; I only pose as a mode of providing the vehicle for that change. Sometimes, clients do not act responsibly, by not doing their homework, and expect the therapist to solve his/her problem. This makes therapy a very slow and tough process because the therapist then has to first deal with such misconceptions.
- Another problem, I quite often face, is intrusion into my privacy. Posing personal questions, irrelevant to the case is quite common, probably because our socio-cultural fabric encourages warm friendly personal relationships rather than a strictly professional doctor-patient relationship. Social networking with the therapist, sending friendly texts, phone calls after work hours are issues that sometimes perturb us.
It is said that, there are no good or bad clients; it is only the therapist who can be good or bad. Most often we, clinicians, try to remember this, but sometimes, we are proved wrong. I think that comes from the fact that clients expect too much and think too highly of our humane capacities. It is difficult to put across the fact that we have limited capacities, and we can not work miracles. We also have our personal lives, and although we try our best to abide by our professional ethics, sometimes it may unfortunately happen that we fail our clients, even by not meaning to do so. That is looked upon as a grave crime, and we clinicians, often find, we have nobody to listen to our problems.
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