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The chartered patient and the damaged doctor

BMJ 1996; 313 doi: (Published 16 November 1996) Cite this as: BMJ 1996;313:1268
  1. Stephen Eisenstein

    What's up Doc? Has it really come to this? Doctors becoming patients in large numbers, and all stress related? Is the nation's health in the custody of a tribe of wimps? Stress of some degree some of the time is part of life in any line of medicine, but this is something more. We live in an age of medical activism which has severely distorted the traditional relationship between doctor and patient. A lot of what is up, Doc, is that there are three in the bed, and one of these is neither the patient nor the doctor.

    The traditional relationship, taught to me as recently as the early 1960s, required an individual patient to make a positive decision to seek medical advice. The patient would never have been sought out, importuned, or bribed to visit the doctor. The arrival of an individual at the door of the doctor of his or her choice created a professional relationship and an unspoken contract whereby the individual vested in the doctor a degree of ownership of his or her medical problem and created a set of obligations on the part of the doctor. There was no perception that any individual had an obligation to become a patient, and good health was not considered a right, but more likely the blessing of good fortune. Failure of treatment would have been considered bad luck, rather than incompetence and bad faith on the …

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