Abdus Salam Khan, MD FACP – July, 2016
The healthcare is changing day by day. It is changing so fast that even the physicians at times are not able to see what has evolved and what has gone out of practice. One can imagine how difficult it may be for patients to take their own health care in their own hands. To make matters more complicated, there is more push towards prevention and also aggressive therapy that sorting out best recommendation at times is beyond the general practitioners domain and require the specialist’s help.
So who should be in charge of peoples personal health. Actually it is very common dilemma and talked issue all over the world. The professionals are considered to be the custodians of the health for a few reasons. They have the medical knowledge needed to understand the function of human body and signs that there may be something wrong before it manifest itself. Secondly they have a duty of constantly updating their knowledge thus any change in common medical knowledge will be reflected through the treatment. Lastly the experience that these professional have add to the knowledge and help them tailor the management with the good mix or knowledge and experience.
Sounds very rosy and easy, but let us add a few more aspects. Financial constraints that make patients visit their physicians less often then appropriate, and similarly not able to follow through on the diagnostic workup for the same reason as well as demanding for less than appropriate medicine due to affordability reasons. Physician traits and time slot dissatisfaction that creates a negative feeling about the physician in the minds of the patients. Chances of error or simply inaccurate diagnosis due to ambiguity of the symptomatology and the vastness of field of medicine.
Practicing medicine for so long has made me think about my role quite often. Who am I to the patient. A problem solver? A problem creator? A pill pusher? A friend? An advocate? And plenty of other roles come to my mind. Going through different scenarios while practicing medicine I cannot recall two situations exactly alike. Then what can be a common thread? What message a patient or a young doctor take from this.
This interaction of a patient with his or her physician can be the best one or a most uncomfortable one because of the dynamics. Both patient and the physician want the best outcome, but how can you guarantee that. Through communication both verbal and non-verbal. Let me caution you here is that a physician has the ultimate responsibility of delivering the best care, yet it is highly dependent upon the patients behavior, both verbal and non-verbal.
How a patient feel when they seek a medical advice when they see the doctor. What message they get when the visit has started and when the visit is over. They both may well understand that they both have limitations when it comes to providing a cure. But a doctor should have a decisive edge when it comes to understanding. If this message is properly communicated then the visit goes very well. The patient puts his/her trust in the hands of the treating physician and gives the physician a chance to provide the best care.
Otherwise the patient goes home with more unanswered questions and a sense of dissatisfaction than he/she came with. They feel that they are alone in dealing with their own issue and that they have to take charge otherwise they will have to face consequences of their minor issue when it gets out of hand. Some of them don’t see doctors again, others become bitter and abuse the system one way or the other. Yet others mix and match different prescription and what not.
Let me tell you what I see and what should it all be. The doctor has too many roles to play, and the good doctor should be able to understand for each of his/her patients what will work for the benefit of the patient. The communication is the key, and then full attention to what the patient has to say. Half of patients satisfaction is when the patients realize that the doctor is standing on their side no matter in what role.. As an advocate, or friend or the deliverer of the good or bad news. More than empathy or the feeling for the patients the physician has to create a situation in which the patient feels that the physicians understand what the patient is going through.
How do you communicate this sentiment. How you make someone feel that they can put their trust in you. Mind you, no one can be know it all or perfect in their diagnostic skills. And the patients understand that the physicians may not be able to cure what they have. Yet they want someone on their side. Some one who can see a human being sitting across the table rather than a bag of different diagnoses and labels. The sooner they realize that they have been acknowledged as a person the sooner they start trusting their physician.
So to answer the question who is responsible for the health of any individual, it seems it is a shared responsibility with the physician being the resource, educator, friend and above all advocate of the patient who cares about the person afflicted by the disease. The patient also has the shared responsibility of knowing about their disease and following through the advice given by the doctor. This way no matter what the outcome is, both patient and physician can feel that they did whatever they could do in taking care of the person afflicted by any disease.
I can be reached at askhan65@yahoo.com