The doctor-patient relationship has changed tremendously over the years. The TV program Marcus Welby, M.D., which aired in the 1960s and the 1970s, illustrates this point. The show represented physicians as paternal and caring. Patients in that era treated doctors almost as if they were magical and all-knowing. Nowadays, such dependency on your physician is unrealistic and even unhealthy. This article explores these changes.
Medical Knowledge Has Grown, but Expectations Remain Similar
Specialization is common now. In older eras, however, general practitioner physicians outnumbered specialists. Back then, doctors projected an aura of omniscience. They seemed able to discern everything there was to know about patients' health, and they dispensed advice in an authoritative way. Patients listened to them, rarely questioning the advice. Then came medical advancements that led to specialization. Doctors' learning curves trended upward, but patients' expectations remained the same. These scenarios are typical now:
Patients who expect doctors to be able to identify all medical issues and to heal patients quickly
Patients who expect doctors to see issues and treatments in black and white (as opposed to shades of gray)
The Information Age, with internet medical research readily available to patients
More medical knowledge and more medical procedures
Doctors with huge caseloads
To expand on the last point, many doctors juggle high numbers of patients. Ideally, these doctors would remember every detail about each patient while also having the time to constantly learn and practice medical advancements. Ideal, but not realistic. Doctor-patient relationships suffer because each side does not quite understand where the other is coming from. Some patients feel disappointed and resentful. Patients have told me that their doctors do not care about them and cannot remember the details of their case.
An Equal Partnership Is Necessary
In some ways, patients do realize that they cannot be dependent on doctors any longer. That is one reason they go online to research their symptoms and medical conditions. However, they still do not fully grasp the enormous burdens that doctors carry, and patients still have somewhat of a learned dependency on doctors. The following things should be happening more often than they are:
Patients taking responsibility for their own health
Patients seeing physicians as professionals who can help treat them, and help monitor their health and well-being
Patients taking active steps to assist doctors
For example, 50 years ago, patients were likely to depend on their doctors to know all the details of medications they took, including any side effects and interactions. Only one doctor (maybe two) would prescribe these medications.
Nowadays, patients must actively take charge of their health by keeping track of the medications they are on, knowing the purpose of each drug and noting any side effects. They should be able to provide any doctor with a list to that effect at any medical appointment. This data helps doctors decide on advantageous courses of treatment. Plus, patients see a varied number of general practitioners and specialists, each of whom prescribes medications. Information can slip through the cracks if patients are not proactive.
The doctor-patient treatment model has shifted from that of a "paternal figure and dependent" to that of partners in health, with patients perhaps having a greater amount of responsibility. Patients should never assume that a doctor knows or remembers everything about their medical background. Doctors, with their huge caseloads and unrelenting demands, will be ever-thankful.