Trust

Relations between doctors and patients are at an all-time low: “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.”

Comments

Anonymous
The training system is no more dehumanizing than it ever was.
What is different is that the patient is not usually the one paying the bill. The bond between doctor and patient that result from mutual exchange is broken. Even non-payers had a bond of sorts once–one of charitable generosity on the one hand and gratitude on the other–now what was once appreciated as charity is an entitlement established by EMTALA. Conversely the sense of gratitude at being given a chance to help and the pleasure of being appreciated has been replaced by resentment.
Anonymous
“medical Web sites have taught patients to research their own medical issues and made them more skeptical and inquisitive.”
Part of your answer is right here. You’re equating being inquisitive with lack of trust. If you’re going to view questions as flags of mistrust and react according to that misjudgment, then you’re initiating the break in the relationship. Just because doctor-patient interactions don’t have the parent-child dynamic that perhaps they once did (which I’d attribute to the impersonal manner with which care is delivered now, rather than any payment theory) doesn’t mean you can’t attempt to understand and build on the dynamic as it currently exists.
Anonymous
I think it is good for a patient to be informed. Plus, even doctors don’t trust other docs. My case in point, I went to a walk-in clinic to refill an allergy prescription. That doc suggested I get a colonoscopy to rule out IBS or Chron’s but I didn’t have cancer. Went to Gastreoenterologist, tried to talk me out of it. Said I was young, had no symptoms, my insurance would not cover me for these reasons and that walk-in docs weren’t the best physicians. All that changed afterwards when it was discovered I had Stage IV colon cancer.
I saw several docs in my great state, they all told me that I could die at any moment, but with treatment only had 18 months. I became informed, found a great place to go several states away, a place to give me hope. A place that let me question everything that was done to me. I even brought my colon cancer books with me to the hospital. That was July of ‘04 and I have been NED since Sept of ‘04.
Even when I had pertusis and I went to my PCP in my city, I informed her that I couldn’t take drugs that would harm my liver. I looked up the drugs on the internet and found out that she didn’t decrease the dose as was suggested. I didn’t want to waste more time or money to see her, so I e-mailed my docs in the other state, they e-mailed me not to take it. I was 4 weeks into the pertusis and the drugs wouldn’t help me.
So I trust the docs in my other state with my life. They are invaluable and answer all of my questions, even if by e-mail or calling them at home. I do not abuse the priveledge. So I think that patients need to become informed to find a good doc.
When I talk to other cancer patients who choose to stay in this state, I am concerned for their treatment. After talking to two of them who were State IV, the docs here said they were cured and didn’t need to be seen by them anymore. One was a lung cancer patient, the other is also a colon cancer patient.
I like the fact that my good docs disagree with each other, then work together to find the best solution for me. I like it when they say they don’t know and look into it. For me, if it weren’t for the internet and asking the right questions and seeking the best care, I doubt that I would be here today.
If I was angry with anyone, it was with my insurance company. They initially denied everything. I received my complete billing statement and could tell you exactly how much I was charged. It surprised me to learn that there were Medical Doctors on this board denying my treatment. I asked them what the insurance company would pay for with Stage IV cc. It had to be more than nothing. A lot of it stemmed from the fact that I should never had had a colonoscopy, since their was no symptoms for me to do so.
I do not blame my initial doctors, however, I do believe if they don’t know, they should encourage their patients to get another opinion and possibly give them names of the big cancer centers that could help. Fortunatley, I had heard of some of the great ones and went there, on my own. But none of the docs I saw in my state suggested I go someplace else. One (a surgeon) even shot me a dirty look when I said I was going to get another opinion. He suggested I didn’t have time. I’m soo glad that I became informed and found the right place for me. I even looked up clinical trials and went to a place that had one that I liked. So, I say, if you don’t like your doc or what they have to say, go someplace else. I’m glad I did.
If I should become unable to speak for myself, I’m glad I have found the right docs to speak for me on my behalf.

Trust

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