Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The commodification of health care is destroying the doctor-patient relationship

Jen Baker-Porazinski, MD
Physician
March 7, 2019
1K Shares
Share
Tweet
Share

My elderly patients miss the days when, in an emergency, they could call their family doctor at home, and they’d be cared for. Retired doctors reminisce about the “good old days” when they were in charge of their own schedules and could prescribe whatever drug or test they felt necessary based on years of experience. While there was a strong doctor-patient relationship in those bygone days, it was not necessarily an equal partnership. Patriarchal doctors expected their advice to be followed and patients generally complied because they trusted their doctors.

Patients today have lower expectations of their doctors, having never experienced a strong bond forged through generations of caregiving. Unless they need a prescription, patients seek out the help of their physician only after exhausting their own resources and well-intended advice from friends. When they do go to a doctor, it’s often at an urgent care or with someone other than their primary physician. The inability of patients to receive care from their own doctor when needed results in fragmented care — frustrating at best, dangerous at worst.

The commodification of health care is destroying the long-revered doctor-patient relationship. Doctors who joined this once-noble profession hoping to make a difference in their patients’ lives are disillusioned by endless paperwork, bureaucracy, and arguments with insurance companies that steal time away from their patients but contribute little to their actual health. Doctors don’t mind working hard when the work is meaningful. But filling out forms and scrolling through computer screens instead of focusing on their patients doesn’t contribute to a sense of purpose — it contributes to burnout. Burned out doctors not only lose compassion for their patients, but they make mistakes. They also leave medicine.

The doctor-patient relationship is complicated. During training, emotional attachment to patients is discouraged in part to protect doctors when patients inevitably become ill or die. Separation is also meant to promote objectivity and (supposedly) better patient care. A recent study by the Harvard School of Public Health, though, calls the latter rationale into question. Researchers demonstrated that female physicians had lower mortality rates and fewer hospital readmissions than their male counterparts. Researchers did not conclude that women doctors were better clinicians but rather that they were more patient-centered and reassuring than their male colleagues. This willingness to spend more time connecting with their patients actually saved lives.

The erosion of the doctor-patient relationship could be dismissed as the price of progress as healthcare facilities become more technologically savvy and rural patients are able to access doctors through telehealth. The potential health consequences of the disconnect, though, can’t be ignored. Exasperated by escalating bills and rushed appointments, patients turn away from their doctors and toward the internet — and the distance widens. Patients with chronic illnesses and high deductibles often only seek out their doctor when they’re sick enough to need hospitalization. Victims of abuse won’t disclose trauma to a doctor staring at a computer screen. When parents no longer trust their physicians, children aren’t vaccinated — a top 10 global health threat of 2019 according to the World Health Organization.

A recent study by social psychologists at Stanford University shows the true cost of the eroding doctor-patient relationship. It turns out that it actually matters to your health if you like your doctor. A doctor’s words of encouragement can improve the efficacy of drugs. Good rapport between doctor and patient isn’t just an added bonus, it’s an essential component of healing. This is something doctors have intuitively known for decades. In a 1926 speech to Harvard Medical Students, Dr. Francis Weld Peabody said: “One of the essential qualities of the physician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”

There are changes that can be made on a national level to help reverse the trend of disconnect between doctor and patient. For one, every American should have access to affordable healthcare. Limits must be set on astronomical copays and deductibles that drive patients away from their doctors. Eliminating the time-consuming and expensive middlemen of bureaucracy would not only help reduce costs but also would give back precious doctor-patient time — time that could be used for health caring.

In theory, technology should free up time and allow doctors to spend more with their patients. Electronic medical records have fallen far short of this ideal, though, increasing provider frustration and further driving patients away. At a minimum, patient information stored in vast electronic files must be made more easily searchable — it should be simple to find out when a patient’s last colonoscopy was, or to compare bone densities, or retrieve all the drugs previously tried for depression. EMR systems should be able to “talk” to one another. Hospitalizations, specialist consults, and tests performed at outside facilities should be seamlessly integrated into a patient’s record. This would prevent duplication of testing and allow easy comparison of results. Doctors should not be wasting invaluable patient time fighting with inefficient and laborious EMR systems.

We don’t need to wait for political changes or technology to improve the doctor-patient relationship, though. Doctors must find a way to reconnect with the compassion that attracted them to the healing profession in the first place — before they became defeated by the business of medicine. We can smile, make eye contact and be curious about our patients. These small acts may be more important than wielding the stethoscope or prescription pad.

Patients should understand that while the credentials of their doctors are important, their connection with them is even more critical. They should seek out doctors whose opinion they trust and who listen and hear what they say. Together, doctors and patients can work to build the doctor-patient team again.

Because, as it turns out, health care actually works better when caring is a part of it.

Jen Baker-Porazinski is a family physician who blogs at Pound of Prevention.

Image credit: Shutterstock.com

Prev

How self-awareness helps with patient interaction

March 7, 2019 Kevin 1
…
Next

A paradigm shift in acute pain assessment and management

March 8, 2019 Kevin 6
…

Tagged as: Primary Care

Post navigation

< Previous Post
How self-awareness helps with patient interaction
Next Post >
A paradigm shift in acute pain assessment and management

More by Jen Baker-Porazinski, MD

  • America’s ailing health care system: How it’s failing patients and doctors

    Jen Baker-Porazinski, MD
  • America is failing primary care doctors

    Jen Baker-Porazinski, MD
  • Caregiving for COVID at home: a physician story

    Jen Baker-Porazinski, MD

Related Posts

  • Osler and the doctor-patient relationship

    Leonard Wang
  • How social media can help or hurt your health care career

    Health eCareers
  • Why health care fails to deliver better value in patient care

    Kristan Langdon, DNP and Timothy Lee, MPH
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • The triad of health care: patient, nurse, physician

    Michele Luckenbaugh
  • Health care organizations: Clean up your house first, then you can tackle racism in patient care

    Nikki Hopewell

More in Physician

  • Heartwarming stories of cancer patients teaching us about life and the human spirit

    Johnathan Yao, MD, MPH
  • We need a new Hippocratic Oath that puts patient autonomy first

    Jeffrey A. Singer, MD
  • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

    Ton La, Jr., MD, JD
  • How can there be joy in medicine if there is no joy in Mudville?

    Arthur Lazarus, MD, MBA
  • Physician entrepreneurs offer hope for burned out doctors

    Cindy Rubin, MD
  • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

    Elizabeth Cerceo, MD
  • Most Popular

  • Past Week

    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician
    • From skydiving to saving lives: a surgeon’s journey on adversity, passion, and perseverance [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • NT-proBNP for All; Risky Weekend HF Admits; Ticagrelor for Infective Endocarditis?
  • Clinical Challenges: Test Your Knowledge of Dry Eye Disease
  • Clinical Challenges: Meibomian Gland Dysfunction Underdiagnosed and Undertreated
  • Best Exercise Time; FDA's Diabetes Guidance; Weight Discrimination Illegal in N.Y.C.
  • 10 Asian Americans in Healthcare Worth Following on TikTok

Meeting Coverage

  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • The Role of Amyloid PET in the Management of Alzheimer's Disease
  • New Inflammation Inhibitor Proves Effective and Safe for Dry Eye Disease
  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Most Popular

  • Past Week

    • How chronic illness and disability are portrayed in media and the importance of daily choices for improved quality of life

      Juliet Morgan and Meghan Jobson | Physician
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Emulating Michael Jordan’s winning mindset: a path to success for health care professionals and entrepreneurs

      Harvey Castro, MD, MBA | Physician
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
  • Recent Posts

    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored
    • A family physician’s journey on the OIG list and the struggle to return to practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Heartwarming stories of cancer patients teaching us about life and the human spirit

      Johnathan Yao, MD, MPH | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • The meaning of death in medicine: the role of compassionate care in end-of-life patient care

      Ton La, Jr., MD, JD | Physician
    • From skydiving to saving lives: a surgeon’s journey on adversity, passion, and perseverance [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The commodification of health care is destroying the doctor-patient relationship
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...