Health Care

When I was a young girl the 'family doctor' was almost like family-he or she treated you with respect, listened to your concerns and cared about whether you lived or died. Insurance was important but not the 'complete fix or answer' to your ills.

The family doctor was just that-part of the family. When there was a health problem, he or she had the solution and was caring and helpful when doling about medical helps.

Today's doctor is talented, sometimes gifted, and knowledgeable about today's medicine but often doesn't have a clue as to what is going on with the patient-be it physical or mental. The office is often jammed with people waiting-sometimes hours on end, often staffed with incompetent help, phones ringing constantly, TVs blaring out endless health information that is usually ignored, and receptionists that are disinterested at best. Disorganization in the office and patient room has become acceptable and the 'norm.'

What is most disturbing to me is the intrusion of the computer in the patient room. Granted, the computer helps the doctor to assemble and organize important patient information but what is it doing to the relationship between patient and doctor? Are doctors relying too heavily on computers to assimilate and then offer up answers to the patient's problems and concerns or are the computers being used to add to the patient's comforts and problem-solving...?

I currently see a doctor who uses the computer and acts as if he would be 'incomplete' without it! How does this make me feel? Glad that I asked myself this and other questions My answers are:

1. I feel detached from the doctor because he's paying more attention to the computer than me.

2. I feel that because he's not communicating much with me, he'll miss something important to my health...

3. I feel that he doesn't care about me; that I'm just a number in a myriad of numbers..

4. I feel that he's using the computer as a crutch; a tool where he doesn't have to interact much-only with the computer.

5. He seems more harried and hurried with the computer-I am to be dealt with quickly and efficiently and then dismissed.

Now, I don't mind him using a computer to help store information but he or she needs to remember that I'm a human being and I need interaction between him and me!

Another thing I see that is causing a breakdown between doctor and patient is the absence of the 'white coat.' Yes, I know that it causes fear in some but, you, know, it also shows respect, professionalism and cleanliness. Without that white coat, he or she looks no more professional than anyone else. Imagine a police or fireman without their uniform when working...Wouldn't it bother most of us if we saw them without their professional uniform? I know it would me.

You see, what I'm trying to say is when it comes to professional people such as doctors, psychologists and psychiatrists, being and acting professional and yet keeping some traditional aspects-such as the coat and talking one on one with the patient-helps to keep that profession healthier, more top-notch and more in-tune with the patient. And when that occurs, then, in my opinion, better healthcare is achieved.

Of course, there are ways in which a doctor can improve the doctor-patient relationship. Some of these ways are described in an online article titled, "Improving the Doctor-Patient Relationship." Some of these ways are, "active listening, nonverbal communication, agendas, empathize, reassurance, avoid overreacting and establishing boundaries." (These suggestions came from a workshop in WI in 2003.)

Another online article, "Building a Cooperative Doctor/ Patient Relationship," discusses ways in which both the patient and the doctor can build a better working relationship. For the patient here are the suggestions, "Sharing your point of view with your doctor, Choosing a relationship style, Learning the information, Preparing for appointments and Getting emotional news.

All of the above whether it applies to the patient or doctor are great but as a patient I must add one more: try and have the office and its employees organized and caring-especially when answering and making appointments on the phone.; particularly if test results are involved. Being disorganized in a doctor's office is most frustrating and wastes time and money for all! The office is the front line of the doctor's business and if it's disorganized, then the perception of negativity will begin. (However, I also must interject that sometimes it is the doctor who is disorganized and spreads this attitude through the entire office. Unfortunately, I have such a doctor and it's most difficult when dealing with him) (Update on my doctor-he is now more organized and professional, has a better quality staff and takes a little more time with his patients.)

To be fair concerning my doctor and those like him I need to remember that he is only human-and most likely is trying to help me to the best of his abilities. Perhaps I need to give him some slack, slow down and let him check me over and give a diagnosis and then follow the instructions for getting well. If I have a question on something he's doing or wants me to do and I don't want to do it, then I need to talk to him in a professional and caring way. Most likely we both can come to an amicable solution.

I offer more thoughts on doctor/patient relationships and phobias:

If you've noticed a difference in healthcare, specifically care from your doctor in the last five to ten years, you're not alone. Healthcare is changing, often daily. That doctor/patient relationship is altering into a kind of 'pseudo' type of relationship. The doctor used to be the one person who would look out for you and keep your best interests to heart. Someone you could trust and confide in...No longer is this the case...

Why we can no longer have this kind of relationship is described in an online article, "Section 1-The importance of the doctor-patient relationship, and why we can't have it anymore." This article comes from YourDoctorintheFamily.com (2004).

This is happening, according to the article, because healthcare in the USA has turned to "covert rationing." This article goes on to explain that 'rationing healthcare has become an absolute economic imperative.' The article further explains that 'We must ration health care and are doing so, economists agree, simply as a matter of demographics and mathematics.'

Another statement is made here that needs to be repeated because it is happening now, "If we cannot ration health care openly, the only other choice (since ration we must) is to ration covertly, that is, to ration while denying that we are rationing at all. And that is what is going on today..YourDoctorintheFamily.com (2004)

One last statement on this issue needs to be made and that is, "Covert rationing requires that decisions made at the bedside be made with society's priorities in mind, and not the patient's. Indeed, covert rationing demands that the doctor forego his primary duty to his patient, in favor of "the greater good."YourDoctorintheFamily.com (2004).

I have to agree with one of the final statements made of covert rationing and that is "covert rationing, and all it entails, ultimately threaten to leave us a fundamentally changed people." YourDoctorintheFamily.com (2004) Nay, I might add, are we being programmed into something 'subhuman?'

There is an interesting picture--"Christ Among the Doctors," by Albrecht Durer (2004). This is a beautiful but disturbing painting that shows Christ among doctors and self-righteous scholars. The main theme of the painting is 'faith versus science and reason.'

I found this picture, "Christ Among the Doctors" unnerving but insightful, in that it shows a contrast between 'world-believers' and 'Christ-believers.' Christians, according to Biblical doctrine are 'in' the world but not 'of' the world. Because of this precise definition and our faith in a 'higher' being, we can put our trouble, worries, physical and mental illnesses in His hands, not in the hands of unbelievers or self-righteous scholars.

Copyright Toni Star 2007