Patients need to contribute to help their doctors

“Be a fountain not a drain,” an expression used by baseball announcer Rex Hudler, is one that has motivational content particularly in terms of an individual included as part of a team.

I would suggest that this expression would be appropriate when considering a basic team in medical practice: the doctor-patient relationship. It is critical in most clinical situations that both the doctor and the patient assume responsibility for making progress toward the goal of diagnosis and therapy and hopefully a cure. The doctor-patient relationship is not one of the patients simply “taking” or “draining” the knowledge and skills of the physician or one of the doctor simply “spouting” those capacities to the patient.

Each member of this team has a responsibility to contribute and not just “take.” That means that the patient must realize that the doctor can usually fail to make a diagnosis without a full history provided by the patient. It also means that to examine the patient, a certain degree of patient cooperation is required for the exam to be of value. And when it comes to treatment, patient compliance is also essential.

On the other hand, the physician should understand that looking at the patient simply as an “object” of a disease and a resource to demonstrate one’s skills for an income is not what the doctor-patient relationship is all about. It is not about “taking” but is about considering the patient as a “subject” of physical and mental concerns giving the patient not only a chance to be physically healthy but also a feeling of comfort in the relationship and support of the patient’s emotional health.

Now, one may argue that the doctor-patient relationship is not really a equally balanced one in that it is the patient who is sick and may be ignorant of the facts of the illness and treatment whereas the doctor is not. Therefore, it should be only the doctor who should be required to be the “fountain” and, well, the patient receiving and taking the results, the “drain.”

Which view do you hold?

Maurice Bernstein is a physician who blogs at Bioethics Discussion Blog

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