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Why doctors and patients have turned against each other

Hans Duvefelt, MD
Patient
September 22, 2011
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“Where there is love of humanity there will be love of the profession.”
-Hippocrates

Reading some of the blog posts and comments on the Internet, you might get the impression that a majority of American doctors hate their jobs. Actually, according Family Practice News, only 35% of my colleagues are unsatisfied with their careers, but that is still a remarkable number.

Are Hippocrates’ words implying an answer to why some doctors today don’t like their jobs? Don’t they love being able to help their fellow human beings enough to overlook the imperfections of the health care system? Or, put another way, is the health care climate in some places so horrendous that some doctors and patients cannot find enough common ground for a caring relationship to develop?

I have read comments by both clinic doctors and concierge doctors that describe their patients as unreasonably demanding and next to impossible to work with. You don’t have to look far to see equally unflattering comments by patients about their doctors.

It seems clear that these imperfect unions are being poisoned by outside influences, which create prejudices or unrealistic expectations. If these unhappy doctors and patients were married couples, we might tell them to split up, get counseling or go on a vacation or retreat and get to know each other all over again. Staying together without changing the bad energy won’t lead anywhere. And just like unhappily married people, if they split up and start over with someone else without learning what part they themselves played in the failure of their relationship, they are at a very high risk for finding the same unhappiness with their next partner.

Who, then, has forced their way into the doctor-patient relationship and turned the two against each other? And why did doctors and patients allow this intrusion?

The intruders promised both of them freedom from responsibility to each other – for the patient, access to doctors without having to pay – for doctors, freedom from asking their client for money, freedom from patient judgments about the dollar value of their services.

The intruders also told doctors and patients what they deserved from each other, instead of letting them iron out their expectations on their own. Patients and doctors were seduced with images of perfect and pliable partners, no more realistic than romantic fiction.

Hippocrates’ words build on love of man and a sense that ours is a noble profession. First, if we imagine our patients at least as distant relatives, we are partway where we need to be in our relationships. Our job begins with finding the common ground that makes relationship building possible. Second, if we don’t accept that our profession has a higher purpose than to do technically good work and reap the financial rewards we deserve, we will never be happy.

If we cannot feel joy and satisfaction when we are able to move a fellow human being in the direction of better health and enjoyment of their lives, we need to return to our own source to feed our souls and renew our spirits.

Ultimately, this is about soulfulness in our work. Many doctors today seem to feel that their work doesn’t matter on some deep level to their own sense of purpose. Relating to our patients as fellow human beings is the very first step in finding that purpose. Without that foundation, everything we do turns too abstract to provide professional pride and satisfaction. It is not sustainable to work as hard as we do if the only ones we help are the insurance companies or the clinic bottom line. Our job is to help people, real people with real problems.

A Country Doctor is a family physician who blogs at A Country Doctor Writes:.

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