An adult relationship with my patients

As a physician, I believe it is time that doctors stop shaking their fingers at patients and scolding them for “misbehaving and not complying.”

Most patients are adults and are increasingly educated and need to be treated that way by their doctors. Also access to previous “secret guild information” that doctors possessed has been profoundly altered by open access to high quality medical information on the Internet.

Also when I interact with my patients as adults, instead of scolding them as “children” I encourage them to enjoy life and engage in what I call responsible pleasures like exercise, laughing, the arts, healthy and responsible sexuality and many other pleasures. I tell them that quality of life is probably much more important than quantity. That the good life is indeed measured not necessarily in length of years but experiences contained in those years. So “more life in years becomes more important that years in life”.

My approach with my patients has evolved over 35 years of medical practice into giving patients, first permission and then encouragement, to responsibly enjoy themselves without unnecessary guilt. I emphasize what they “can” do instead of what they “can’t.” I call these “behavioral prescriptions” –instead of, or in addition to pills, as a prescription.

One older depressed man who was my patient was struggling with health, family and financial issues told me with gratitude that I was the first person in his entire life of 70 years who ever told him it was ok for him to cry. We then both then smiled in harmony, with mutual respect and in a moment of mutual healing.

Finally, I have come to believe that the most important obligation that I have, as a physician, is to help my patients to become themselves. Healing powers then flows from that achievement.

The excesses of paternalism in my practice of medicine have been replaced by a much more rewarding adult to adult relationship with my patients. Not shaking my finger at them or scolding them as “children” has helped them and me more than you can imagine.

This I believe.

Rick Lippin is a physician. 

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