After 40 Years, Patients Still Crave Attention and Respect

Monday, May 4, 2009 21:22

The Doctor/Patient Relationship

By Barbara Ficarra, RN, BSN, MPA

What do patients want?  Despite the technological promises of the Health 2.0 movement, in some ways it’s really no different today than it was forty years ago.

An article that appeared in Time Magazine on May 13, 1966 says:

Today, Americans get far better medical care than ever before; as for the rest [of the doctor-patient relationship], they are often lucky to get as much as a hurried smile. The result is a troubling paradox: at a time when medical skill has reached new pinnacles, the doctor-patient relationship has badly deteriorated. It is a situation that both irritates the patient and worries the medical profession.

In 2009, it’s much the same: Patients today often feel rushed during the “fifteen minute” office visit.  They feel the doctor-patient relationship is dwindling since there’s not much time to communicate.  And they crave attention.  They have questions and they want answers.

I recently attended the Health 2.0 Meets IX conference in Boston where the overall theme was how to engage patients.  According to those at the conference, doctors want their patients to be proactive and they are learning  that communicating, collaboration and partnering with their patients are critical.

A lot of the talk was about how technology can help: patients can connect with doctors via social networks and e-mail, they can connect with each other, and all sorts of devices can provide treatment and diagnostic information that will make care more efficient.

But none of that changes the underlying need for connection between patient and doctor.

“Patients and physicians must be partners in the patient’s health.  To do this requires mutual respect.   It comes down to listening, communicating and understanding,” says Dr. Daniel Z. Sands, Director of Medical Informatics at Cisco IBSG and a primary care physician at Beth Israel Deaconess Medical Center.

Back to 1966:

In a word, the U.S. medical profession is trying hard to get back to a principle as old as Hippocrates'; it is rediscovering that there is still healing power in the laying on of hands. In an area where the stakes are life and death, but where the modern doctor knows that nothing is finally certain, he can still only say to his patient: “Trust me.” Today’s patient, who is sophisticated enough to realize his doctor’s limitations, is willing to extend that trust-but in return he wants some understanding and sympathy, the vital ingredients that nowadays are too often missing. That exchange should be a compact between the patient and his doctor. It is a compact less complete than the old one, which was based on the patient’s total faith and on far less knowledge, but it is a more realistic one.

Not only are patients being engaged into social networking sites and new technologies.  Patients still want to be engaged with their doctors–and want collaboration and respect.

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8 Responses to “After 40 Years, Patients Still Crave Attention and Respect”

  1. DrV says:

    May 6th, 2009 at 10:28 pm

    Excellent post. Patients are in a tricky spot. They want independence and autonomy but they also need a relationship with a clinician. It will be interesting to see how this is all reconciled. Gonna post this one to my delicious page

  2. Barbara Ficarra says:

    May 7th, 2009 at 4:23 pm

    Hi Dr V. Thanks! I agree with you. Despite the autonomy they crave they want a relationship. Thanks for posting on your delicious page too.
    Best,
    Barbara

  3. Julie Rosen says:

    May 12th, 2009 at 12:50 pm

    Hi Barbara,

    Fascinating. I blog about compassionate health care at http://www.everydayhealth.com/blog/schwartz-center-bedside-manner/, so I found the TIME story/essay particularly intriguing. While we often blame managed care for the demise of the patient-doctor relationship, the roots of the problem are much older, as the piece shows. Although the essay seems almost quaint to readers today, so many of the issues it raises are still with us. I chuckled at the section about resentment towards doctors’ high salary. The average doctor in 1966, as the piece points out, earned $28,380!

  4. Barbara Ficarra says:

    May 12th, 2009 at 6:18 pm

    Hi Julie, Thanks so much for your comments. It is interesting to see that issues facing the doctor/patient relationship today were very much part of the past. I also chuckled at the part where there was resentment towards the doctors salaries! It was enjoyable to read a piece dated from 1966. Thanks again.
    Best,
    Barbara

  5. Maryalice Jordan-Marsh says:

    May 18th, 2009 at 6:19 pm

    Paying attention to the two sides of the provider (DNP, MD, NP, etc.) relationship is as important as the two sides in any relationship. This discussion is very important as we all have had little coaching on etiquette now that the Internet and digital social networking have entered the equation. Is it polite for the health care professional to suggest an online group? a health info website? to require visiting a decision-making support website before the next visit? to suggest a serious/health game after a diagnosis that is complex?

    How do clients/patients bring Internet based information to the interaction in a respectful, time efficient manner?

    I propose that we conceptualize health habitats (Jordan-Marsh, 2008) where all of the players recognize the complexity of sustaining or regaining health in a sometimes hostile world. Many physicians are building “medical home” arrangements to coordinate their services. This new and appealing concept is an important step forward, but it is only one niche and implies a central focus on medicine (rather than a team with patient at the center of a transdisciplinary network) and is a static place. If we reconceptualize health as occurring in a habitat, it will be more obvious that our environment, human interactions, social capital, health capital, spiritual resources and economic capital all matter–they can be symbiotic, sychophantic or downright harmful. An ecological perspective could turn around the ‘mess” we are in. Digital resources can be partnered with human resources for smart homes, medical homes, and full utilization of pre-Internet knowledge and tools.

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