The Doctor/Patient Relationship: Why Care?
Posted by Dr. Vollmer on June 26, 2013
“It’s more important to know what sort of person has a disease than to know what sort of disease a person has.”-Hippocrates
I am not so sure. As I think about Hippocrates famous quote, I want to argue with him, as being too simplistic. When it comes to hypertension, diabetes or depression, I completely agree that understanding the person with the disease is more critical than understanding the disease, by itself. However, if this same person had a rare blood cancer, then the first order of business is to understand the disease, treat the disease and then, or at the same time, try to understand how this rare disease impacts this particular person. As a patient, my first priority is to become disease-free, and then my second priority is to have a doctor who understands what my disease put me through. Ideally, the treating physician is the same person as the understanding physician, but with the change in health care, this is likely to be two different people, and the latter is not likely to be a physician. Hence the main therapeutic relationship is likely to be with a non-MD, and on the face of things, I think that is fine for most situations. What I moan about is the rare event where it is critical to have a doctor who is both diagnostically sophisticated and deeply compassionate. For prolonged illnesses, such as those dealing with heart transplants, it is helpful if the physician is both sophisticated with the nuances of anti-rejection drugs, while at the same time, understanding of how this transplant has significantly altered this patient’s daily life. Most of us, though, do not have rare illnesses (redundant, I know), and hence most of us need someone to remind us of how to take care of ourselves, while another caring soul can help us integrate our medical problems into a new understanding of ourselves. So, my response to Hippocrates-“it depends”.