Being an Eye Patient in 2006: Revised Job Description
Familiar with the adjective paternalistic? Its root is pater, Latin for 'father'. The Lord's Prayer (the 'Our Father') would always begin "Pater noster...". Thank you, Sister Mary Loretto, you taught me well!
Medicine used to be very paternalistic. The physician examined you, ordered tests without explanation, and initiated treatment - medical, surgical, maybe both. There was very little dialogue. Most patients didn't complain because they genuinely assumed that the doctor knew what was best and that the doctor would always act in the patient's best interest. That's the way people also felt about their parents. The doctor was almost like a third parent, except instead of giving you an allowance you received a bill!
Health care reform, combined with the economics of managed care, has mostly obliterated all paternalism - both the good aspects and the not-so-good. Patients are reclassified as health consumers although most of my patients cringe when they hear that phrase. The rules have changed and most of you know that.
Click here to read how one doctor is trying to unleash the power of health consumers to improve health care delivery. Because I have been practicing a long time I am uncomfortable putting new burdens on patients. They're sick, they're scared, they already have enough to think about!
But what if it made a real difference in the quality of care and the outcomes?
Maybe among all these changing paradigms (cringe!) there is a place for health consumers to take a more active role. Here's a little secret taught in medical school: Patients are looking for good doctors. At the same time doctors are looking for good patients!
What do I look for in good patients?
= Active listeners
= Helpful historians (notes are cool)
= Folks eager to learn more about their health, not just their diseases
= People brave enough to ask 'why?' at least once per visit
There are many, many more attributes but first I'd like to hear what you think.
As you know, I am unable to respond directly to blog comments, but feel free to take it over to our WebMD Eye & Vision Disorder Community Member Board to kick-up some fresh dirt with a doctor who is still trying to adapt.
Related Topics: Finding Dr Right, Choosing a Health Plan
Technorati Tags: healthreform, managedcare, communication
Medicine used to be very paternalistic. The physician examined you, ordered tests without explanation, and initiated treatment - medical, surgical, maybe both. There was very little dialogue. Most patients didn't complain because they genuinely assumed that the doctor knew what was best and that the doctor would always act in the patient's best interest. That's the way people also felt about their parents. The doctor was almost like a third parent, except instead of giving you an allowance you received a bill!
Health care reform, combined with the economics of managed care, has mostly obliterated all paternalism - both the good aspects and the not-so-good. Patients are reclassified as health consumers although most of my patients cringe when they hear that phrase. The rules have changed and most of you know that.
Click here to read how one doctor is trying to unleash the power of health consumers to improve health care delivery. Because I have been practicing a long time I am uncomfortable putting new burdens on patients. They're sick, they're scared, they already have enough to think about!
But what if it made a real difference in the quality of care and the outcomes?
Maybe among all these changing paradigms (cringe!) there is a place for health consumers to take a more active role. Here's a little secret taught in medical school: Patients are looking for good doctors. At the same time doctors are looking for good patients!
What do I look for in good patients?
= Active listeners
= Helpful historians (notes are cool)
= Folks eager to learn more about their health, not just their diseases
= People brave enough to ask 'why?' at least once per visit
There are many, many more attributes but first I'd like to hear what you think.
As you know, I am unable to respond directly to blog comments, but feel free to take it over to our WebMD Eye & Vision Disorder Community Member Board to kick-up some fresh dirt with a doctor who is still trying to adapt.
Related Topics: Finding Dr Right, Choosing a Health Plan
Technorati Tags: healthreform, managedcare, communication
3 Comments:
You should see the paternalistic, condescending attitude of the British GP who refuses to refer a patient to the USA nor can describe a T3Cap diagnosis to his patient. This UK GPs are only referral experts for their incompetent cronies!
Hello Dr. Lloyd,
I found your blog very interesting! Frankly, it did not ever occur to me that a dr. might be LOOKING for a 'good patient'. If I were seeking an opthamologist, I would be happy to make an appointment with you!
It is my experience that I am talked down to, my questions are not answered, tests are not explained beforehand nor results told to me, even if I ask, on the pretext I couldn't handle the news. Also, my experiences and recollections of my health are disregarded. It is presumed I am either elderly or stupid (I am 58).
Speaking of paternalism, a recent dr. told me to 'trust him' and 'not to worry' about my kidney disease...shades of the 1950's. I wanted to throw up!
Well, thank you for listening and asking for comments!
kr1947
Hi,I really appreciated your comments on The Doctor looking for good patients.I personnaly learned this when I finnally began to "listen" to "everything" my Doctor was talking to me about,not just what "I" wanted to hear.I found that my Doctor's and my relationship quickly grew to one of mutual respect after that.I feel much more comfortable talking to my Doctor now,and I feel her comfort also,us Patients seem to forget that Doctors are people too,who also deserve to be herd,I know that for the first time in all my Doctor/patient relationships,I truley feel a friendship with my Doctor,and who better to go to when your feeling bad? Your Friend! Rose
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