[Full text: http://www.nytimes.com/2008/07/29/health/29well.html?ref=science]
Doctor and Patient, Now at Odds
By Tara Parker-Pope, New York Times, July 29, 2008
“A growing chorus of discontent suggests that the once-revered doctor-patient relationship is on the rocks. . . increasingly, research and anecdotal reports suggest that many patients don’t trust doctors. . . The Internet is bristling with frustrated comments from patients.
“Doctors say they are not surprised. “It’s been striking to me since I went into practice how unhappy patients are and, frankly, how mistreated patients are,” said Dr. Sandeep Jauhar . . .“Nobody is talking to the patients,” Dr. Jauhar went on. “Everyone is so rushed. I don’t think the doctors are bad people — they are just working in a broken system.”
“The reasons for all this frustration are complex. Doctors, facing declining reimbursements and higher costs, have only minutes to spend with each patient. News reports about medical errors and drug industry influence have increased patients’ distrust. And the rise of direct-to-consumer drug advertising and medical Web sites have taught patients to research their own medical issues and made them more skeptical and inquisitive.
“’Doctors used to be the only source for information on medical problems and what to do, but now our knowledge is demystified,’ said Dr. Robert Lamberts, an internal medicine physician and medical blogger in Augusta, Ga. “‘When patients come in with preconceived ideas about what we should do, they do get perturbed at us for not listening. I do my best to explain why I do what I do, but some people are not satisfied until we do what they want.’
“Others say the problem also stems from a grueling training system that removes doctors from the world patients live in. ‘By the time you’re done with your training, you feel, in many ways, that you are as far as you could possibly be from the very people you’ve set out to help,” said Dr. Pauline Chen. . . We don’t even talk the same language anymore.’
“Dr. David H. Newman, an emergency room physician at St. Luke’s-Roosevelt Hospital Center in Manhattan, says there is a disconnect between the way doctors and patients view medicine. Doctors are trained to diagnose disease and treat it, he said, while ‘patients are interested in being tended to and being listened to and being well.’
“Dr. Newman, author of the new book “Hippocrates’ Shadow: Secrets from the House of Medicine” (Scribner), says studies of the placebo effect suggest that Hippocrates was right when he claimed that faith in physicians can help healing. ‘It adds misery and suffering to any condition to not have a source of care that you trust,’ Dr. Newman said.
“But these doctors say the situation is not hopeless. Patients who don’t trust their doctor should look for a new one, but they may be able to improve existing relationships by being more open and communicative.
“Go to a doctor’s visit with written questions so you don’t forget to ask what’s important to you. If a doctor starts to rush out of the room, stop him or her by saying, ‘Doctor, I still have some questions.’ Patients who are open with their doctors about their feelings and fears will often get the same level of openness in return.
“All of us, the patients and the doctors, ultimately want the same thing,” Dr. Chen said. “But we see ourselves on opposite sides of a divide. There is this sense that we’re facing off with each other and we’re not working together. It’s a tragedy,”