Shirah Vollmer MD

The Musings of Dr. Vollmer

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”.

3 Responses to “The Doctor/Patient Relationship: Why Care?”

  1. Shelly said

    I certainly don’t agree with Hippocrates and given the choice of a brilliant diagnostician or a kind, compassionate and caring physician, I would choose the later. Of course if I could find one who is both (like you), that would be fantastic. What good is someone who can cure the masses when the physician couldn’t care less about me? Physicians seem to forget that we, the patients, give them the privilege to attend to our bodies (and minds), and that they take this privilege for granted and often abuse it. The compassionate physician understands this and doesn’t seem to forget this and doesn’t make himself feel superior at the expense of the patient.

    • Jon said

      Like Shelly, I will take an inclusive or.

    • Yes, patient care is a HUGE privilege. This was drilled into me during my training and I am appreciative of that. I am afraid that this message is no longer sent to the current rookies and the implication of this is hard to discern. At the same time, the advance in technology has made this less important, under certain circumstances, so one must hope that if he or his loved ones take ill, then there is either the right technology or the compassionate physician, or in the rare instance, both, which can help him through this scary experience. The point of this post is that the rapid change in technology has helped many patients, such that they can seek their compassionate care from non-MDs. Compassion during times of illness are critical, but I am not sure that this compassion always needs to come from the physician. Thanks to both!

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