The Doctor/Patient Divide: As Far Apart As Ever?


Yesterday I re-blogged Alexandra Fulford’s post commenting on an article which appeared in USA Today.  According to Niam Yaraghi patients are incapable of managing or understanding their own health and should leave it all entirely up the medical professionals.

“Patients are neither qualified nor capable of evaluating the quality of the medical services that they receive. How can a patient, with no medical expertise, know that the treatment option that he received was the best available one?”

This morning I woke to another robust discussion, this one prompted by a new promotional video launched by The Royal Australian College of General Practitioners which charts the changing role of a general practitioner in providing health care to patients.

What’s interesting is how reactions to this video, which has been met with acclaim by doctors, have highlighted once again a continued lack of recognition and respect for the changing role of patients in the doctor/patient clinical consultation.

Here is how Michelle Roger, who lives with dysautonomia, views the video:

It was one sided and the patients appeared little more than props to be talked at. In fact the patients had no voice at all. A problem that still permeates a lot of medicine.

Jen Morris, who like Michelle, is a passionate and outspoken patient advocate, observes:

From a patient perspective, the most glaring thing about the ad is that across 90 seconds, encompassing 10 consultations, the GP dominates 100 per cent of the dialogue. No patient or their family member says a word. Not one word. The two minute version is no better. As a result, the campaign represents the idealised ‘good GP’ as one who delivers news – and commands – to artificially muted patients. No conversation. No questions (from patient or doctor).

Every day in the course of my work, I come across patients, doctors, nurses, and allied health professionals, who work tirelessly to transform the traditional doctor/patient paradigm – one in which doctors hold all the answers, and patients must comply with their medical expertise. A few months ago, David Gilbert, yet another passionate and outspoken patient advocate (yes, there are many!) took an analytical, evidence-based approach, using his research as a CLAHRC NW London fellow, to outline seven key benefits patients bring as partners in healthcare.  It’s deeply depressing therefore this week to have the face the reality that for all the patient-centred care rhetoric that abounds, we are still a long way from recognizing that health expertise lies outside as much as inside medical circles. We can’t just talk about a commitment to patient centred care– we have to live it. It is only by bridging the divide which places patient and doctor expertise on opposite sides that we can achieve more personalized and meaningful care of the patient.

The question now is how do we start to bridge that divide in tangible and meaningful ways?