In a recent episode of the television series, The Good Doctor, a patient played as Robbie Ato does not tell his doctors he has a history of cancer.  You can see his surgeons stare in disbelief as one consulting surgeon recognizes the patient’s name and then alerts the team leader that she treated him three years ago for cancer.

This is one of the very most troubling and dangerous acts of negligence a patient projects onto his medical care provider.  Whether it’s surgery, medications or treatment, the human body does not disconnect and disassociate just because the patient doesn’t give a complete map of diseased body parts.

Since the human body works together, in unison and one body part can’t ignore another, patient history becomes an ever-growing part of the patient’s record.  The patient would do well to learn from this example.  Yet, patients are not taught what their responsibilities are to ensure better outcomes. There’s a reason social, current and past medical, and family history is found in every patient’s chart. Providers recognize the value of history but not so with many patients. They will hide their history from providers for fear it will raise their insurance rates, deny them Long Term Care coverage or their providers will judge them.  In the case of Robbie Ato, he was in denial, something most patients do, especially when habitual over-eating and smoking are discussed.

Perhaps one reason this show has such high ratings might be in the nature of Dr. Shaun Murphy (played by Freddie Highmore) who tells it like it is.  The patients don’t seem to be too upset by the honesty.  The bluntness in his voicings unravels the professional team around him.  Is this because Dr. Murphy is being too blunt or perhaps it’s because the patient starts asking tough questions and the team is left to answer them.

Is it truly a problem for providers to answer questions and address patient concerns?

Would softening the approach ease the pain or the make diagnosis less severe?

To each their own, and no perfect answer exists.  The real pearl is hidden in the patient-doctor relationship and the time they spend together talking through concerns, plans, and fears, so trust solidifies rapport, and rapport begets respect. The hospital environment creates a positive spin albeit not a realistic one. Everyone seems to have plenty of time.

But alas, in real life, health care systems don’t pay providers on how many minutes they spend with one patient, but on how many patients can be seen within minutes.

So, there lies the root cause.  Charts will remain incorrect, patients will continue to hide their histories, while health care systems focus on their own well-being. Who will support the physicians?

Suzanne Fiscella is a patient advocate and founder, Patient Best.

Image credit: Salt Lake Tribune