Reconciling the two perspectives is the challenge of a mature partnership
Dear Sir
Doctors are arrogant, paternalistic, poor at communication and
steeped in their own values. Patients have unrealistic expectations, make
unreasonable demands, are quick
to complain and are unwilling to accept responsibility for their own
health.
Reconciling these two perspectives is the challenge of a mature
partnership between doctors and patients. Part of the problem is the use
of stereotypes. The quality of debate would be improved mightily if it
took as its starting point the proposition that we are all made of the
same flesh, that we all have our faults (admittedly some more than others)
and that we all make mistakes in our dealings with others.
Equally important is the fact that doctors and patients do differ in
one crucial respect. Doctors perceive matters relating to illness and
health in an entirely light from that of their patients. Any doctor will
be able to recall the moments during his or her training when they
realised that not everyone gets better. That realisation is not simply
rational, it is emotional. It amounts to a loss of innocence about what
medicine can and cannot do. The general public may be intellectually aware
of these uncertainties
but, with relatively few exceptions, would prefer to believe that this
reflects the limitations of the individual doctor. It is frequently said
that doctors fail to communicate. Some of the time, it may be more
accurate to say that the message is one the patient would rather not hear.
Yours sincerely
Dr J Hopkins
Reference:
A Coulter Paternalism or partnership? BMJ 1999; 319:719-20
Rapid Response:
Reconciling the two perspectives is the challenge of a mature partnership
Dear Sir
Doctors are arrogant, paternalistic, poor at communication and
steeped in their own values. Patients have unrealistic expectations, make
unreasonable demands, are quick
to complain and are unwilling to accept responsibility for their own
health.
Reconciling these two perspectives is the challenge of a mature
partnership between doctors and patients. Part of the problem is the use
of stereotypes. The quality of debate would be improved mightily if it
took as its starting point the proposition that we are all made of the
same flesh, that we all have our faults (admittedly some more than others)
and that we all make mistakes in our dealings with others.
Equally important is the fact that doctors and patients do differ in
one crucial respect. Doctors perceive matters relating to illness and
health in an entirely light from that of their patients. Any doctor will
be able to recall the moments during his or her training when they
realised that not everyone gets better. That realisation is not simply
rational, it is emotional. It amounts to a loss of innocence about what
medicine can and cannot do. The general public may be intellectually aware
of these uncertainties
but, with relatively few exceptions, would prefer to believe that this
reflects the limitations of the individual doctor. It is frequently said
that doctors fail to communicate. Some of the time, it may be more
accurate to say that the message is one the patient would rather not hear.
Yours sincerely
Dr J Hopkins
Reference:
A Coulter Paternalism or partnership? BMJ 1999; 319:719-20
Competing interests: No competing interests