Due to Health Technology and the increased focus on Consumerism in Health-care, the Doctor-Patient Relationship is changing as fast as Congressman Anthony Weiner’s explanations about his Twitter transgressions.  All jokes aside, however, this is becoming a real problem for BOTH parties as Doctors try to service (and grow) their existing Patient Populations while simultaneously deal with increasingly challenging Health Insurance Company/Payor Productivity Payment Requirements and Patients literally don’t know what to do with their sudden “Patient Empowerment” which they keep hearing about from Dr. Sanjay Gupta on CNN.  As with anything else in Life, things ALWAYS come back to BASICS.  Thus, if you focus on Simplicity and treat others the way you would want to be treated, you can’t go wrong.  But how do we do that to fortify the Doctor-Patient Relationship in a 24/7, 365-day world of Health Care Social Media (“HCSM”) in which just one negative comment by a disgruntled Patient (or one with a basic personality conflict with the Doctor) can initiate an unfair world-wide Professional Reputation attack on a Medical Professional who was just trying to do his or her job?

As an almost 30 year sufferer of the Chronic, Incurable and Auto-Immune “Crohn’s Disease,” I have  had dealings with Doctors who have possessed a broad set of great, good and bad traits such as: gifted and compassionate; poorly skilled; poor communicator; excellent but with bad bedside manners (these are usually Radiologists by the way!); arrogant; strictly business (while being  closely examined – “Michael, your Surgical Wound looks like it is healing fine but did you know that you have an outstanding balance of $249,86?”); so myopic toward their own Specialty that if an ax were lodged into my forehead and they were a Pulmonologist they would give me the “all clear;” and bad listeners.  Given this continuing eye-opening experience, I have learned that the foundation of the Doctor-Patient Relationship rests on: Communication, Collaboration, Mutual Respect and Trust.

However, this foundation is a Two-Way Street as I find the most common problem with Doctors to be their refusal, reluctance or mere forgetfulness to use their most effective diagnostic tool, i.e., LISTENING.  Often times, their failure to Listen is driven by the extraordinary Diagnostic Testing Tools at their disposal such that it is now likely that a Test Result will tell them what they think they need to know, and thus they shun all Patient expertise no matter the Disease, Duration of Disease or constructive comment from the Patient.  Doctors should know better as Patients are PEOPLE and sometimes even the most technologically advanced diagnostic test will miss something so obvious or it will pick up on something completely irrelevant such that each miss or misdiagnosis could have been quickly dismissed by the Patient.

That said, Patients have an obligation to be succinct out of Respect for the Doctor’s Available Time when they do speak, elaborate or ask questions in an unsolicited manner during a consultation or examination with a Doctor since the Doctor is up against time constraints the Patient is unaware of and as a result the Patient is only allotted a certain amount of it and therefore it must be used wisely and for that Patient’s benefit.  But when the Patient “permits” the Doctor to do his or her job, this enhances the relationship for the next interaction – whenever that will be.  This “interplay” of sorts is where the Mutual Respect notion comes into play.  As the Joe Friday character from TV’s “Dragnet” would often say or infer, “Just the Facts, ma’am.”  Patients would be wise to be mindful of that same approach during the Doctor-Patient consultation/examination.

I also think Communication, Collaboration, Mutual Respect and Trust is most solidly built when both parties are conscious of establishing “consistency” because the Doctor-Patient Relationship requires a certain “familiarity” between the two (2) to afford enough time for each to best understand the other.  Over time, this comfort with one another breeds Trust and Credibility.  [This is why changing Doctors because of changes in Health Insurance Coverage is so difficult on Patients and I think almost discriminatory against chronically ill Patients like myself who count on a long-established relationships with particular Doctors in most efficiently treating Disease flare-ups.  It is also more cost-efficient but since the Health Insurance Companies operate their businesses like Oil Cartels, they don’t care about Efficiencies of any kind for if they did we would at least see Electronic Medical Records (“EMRs”) in place YEARS AGO.]

In summary, the Doctor-Patient Relationship is Fine; it just needs to get back to Basics.  Additionally, if “nurtured” properly, this professional relationship typically gets better over time.  If it does not, however, THEN it is time for the Patient to find a new Doctor.  Conversely, when the Doctor-Patient relationship stagnates and its lack of usefulness for the Patient is NOT apparent to the Patient (and that can easily happen  for a number of innocuous reasons), the Doctor should tell the Patient that he or she would be better served by another Doctor – especially in this new Global HCSM environment in which the possibility of an almost instantaneous unfair Reputation Attack is only a Tweet or  Click away.  BTW – that’s how a Doctor should handle unfair criticism that is posted in HCSM.  If it has malicious intent, call an Attorney but if it is simply a Patient venting, just stick to certain rules, be fair to all Patients, and treat your Patients as “People” AND in the manner YOU would want to be treated if they were the Doctor and you were the Patient.