Gap between how patients and doctors see patient-doctor relationship


Well-Known Member
In a blog post titled "The Decline and Fall of the Doctor-Patient Relationship,"Paul Keckley discusses the expectations and needs of both parties in the US medical system. The article doesn't address the relationship between doctors and patients suffering from chronic illnesses, particularly one that is as poorly understood as ME/CFS.

The physician-patient relationship is a bedrock of the U.S. health system. Strong relationships are associated with higher ratings for physicians and better outcomes for patients but there's a catch.

In Secretary of Health and Human Services Tom Price Senate confirmation and many times since, he has vowed his administration will seek to restore that relationship. But what patients associate with a strong relationship is increasingly at odds with how physicians think. And the gap between the two seems to be widening.

Not dead yet!

Well-Known Member
Thanks for bringing this up, it is indeed a important issue.

This part:

"The democratization of medical knowledge via social media and readily accessible clinical guidelines from reputable sources means patients have more questions and are often armed with inaccurate or harmful information."

So they're saying clinical guidelines are inaccurate or harmful? I'd agree with that. But I assume that's not what they mean. The whole sentence has issues. For example, I wouldn't characterize "social media" to be part of "democratization of medical knowledge." I'd consider PubMed and similar websites to be though.

I might find an idea on a social site, take that to reliable places like Pubmed, then discuss it with people, including my doctors, before putting it in practice. Doing so has increased my quality of life.

I think, with ME/CFS, this is the only way to survive or find any answers that help.

The problem is not that doctors have egos. Everyone has an ego. The problem is the apprentice system that "trains" doctors to do as others do, and not as they think will help. I think doctors need to be free to do what they think is best for a patient, even if it doesn't fit anybody's guidelines. And they need to be able to do it without fear of censure by, most likely, the insurance companies. That's why we have functional medicine MD's now.

This part:

"Most think their physicians should leverage online technologies to allow online scheduling, tele-visits, secure messaging and more. (Most practices permit online bill payment and little more)."

Besides the garbled sentence above, this part makes me suspect that they're really out to sell a product. My beloved MD bought one of these wowza products and ever since then, hasn't been paid by the insurance company because they claim he is "out of network." It's been 8 months. These products are death to the downhome MD.

Also, I never use such things. You'd have to be severely deluded to think that your medical info (which doctor you see and when) is private on the internet. Calling someone for an appointment isn't such a big deal. And my reaction to the construction "secure messaging" is wry laughter. I have never asked for such extras.

I understand that many people find Skype helpful for ME/CFS, and it can be, especially with some specialist doctors who aren't available if a person has to travel far. But I see that as a necessary stopgap, not as a usual method of doing things.

As a former IT professional, I think people need to be very careful when they mix technology with medicine. For one thing, it throws HIPPA out the window to do that. You can't ever ensure that you're not being logged (overheard).

Finally when you read the end of the article with all those bullet points, you find that they make predictions about things they cannot possibly know. Physicians are already fighting back against having more and more dumb "guidelines" to follow. And the "patients will have more skin in the game" part? First, why are they calling it a game? Second, there's no value in an insurance company that doesn't pay. They tried that with car insurance and they got criminal indictments for it.
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