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The Doctor-Patient Relationship: Part One

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The Doctor-Patient Relationship: Part One

When I was training to become a physician, the rules of the broken, outdated, patriarchal medical system were made clear to me. They went something like this.

The Old Medicine

As your doctor, I will sacrifice everything in my personal life in order to fix what is broken in you. I will stay awake when Iím exhausted, cross my legs when I have to pee, ignore my stomach when it growls, neglect my partner and children when they need me, allow my health to decline, and read all my medical journals so I can stay up to date on the latest in modern science. I will show up sick to work, endure unspeakable traumas in order to learn what I need to know to be an excellent physician, and I will prioritize medicine over everything else in my life. I will study what my forefathers have learned, attend lectures, consult with other physicians, practice my skills, follow the Hippocratic Oath, and vow to first do no harm, and then, hopefully, to do some good.

I will ask you questions, take notes when you talk, interpret your vital signs, and listen to the rhythms of your most crucial organs. I will order laboratory tests and X-rays to figure out whatís wrong, write prescriptions to treat you, refer you to a specialist (if I canít figure out whatís going on), operate when needed, and cover up or cut out any symptom that threatens to disable or destroy you.

Trust Me

As your doctor, I will bring to our relationship the hallowed knowledge of the best of modern science, the wisdom I have earned from years spent in ivory towers, the gifts garnered from the most gifted clinicians Iíve trained with, and the hard-won experience of practicing my craft. I will filter your health problems through the lens of my collective knowledge and churn out a diagnosis, a treatment, and a genuine desire to help you get well.

As my patient, you will trust my expertise, refrain from questioning my judgment, have patience when I make you wait, forgive me when Iím curt, keep your questions to a minimum because Iím very busy, and pay your health insurance premiums so I can give you the best care possible.† As my patient, you will follow up with all recommended tests and comply with all treatment plans, even if you donít understand or agree with what Iíve ordered, prescribed, or recommended.

As my patient, you will fill out all paperwork, jump through all hoops, get child care when you need it, take time off work, find transportation, and make any other arrangements necessary to prioritize your health, but if I have to cancel on you, you will understand, because some of my patients are sicker than you.

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Lissa Rankin

Lissa Rankin, MD is a mind-body medicine physician, founder of the†Whole Health Medicine Institute training program for physicians and other health care providers, and the New York Times bestselling author of†Mind Over Medicine: Scientific Proof That You Can Heal Yourself.† She is on a grassroots mission to heal health care, while empowering you to heal yourself.† Lissa blogs at†LissaRankin.com and also created two online communities -†HealHealthCareNow.com and†OwningPink.com. She is also the author of two other books, a professional artist, an amateur ski bum, and an avid hiker. Lissa lives in the San Francisco Bay area with her husband and daughter.

25 comments

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11:03AM PDT on Aug 26, 2011

Interesting.
Thank you

12:37PM PDT on Jul 8, 2011

According to this model, my doctors were supposedly reading medical journals to stay current... that's not true. My overall health has taken a serious blow in the form of permanent and disabling damage because I trusted doctors who don't know anything.

I'm quite grateful you'll be doing something to change the system. Lead by example.

In the meantime I am homeless and working as hard as I can to come up with the $100k I need to get the rest of the tests I know I need, and the surgeries I need to function properly now that my body has been screwed up by doctors. Hopefully they don't kill me. Maybe I should just go to medical school so they don't.

12:06PM PDT on Jul 8, 2011

Noted with interest.

2:31PM PDT on Jul 7, 2011

Like so many other comments I'd like to hear about a new paradigm (sic). Also, Docs need to know more about drug and alcohol addiction!

10:32PM PDT on Jul 6, 2011

I have been to MD's who suscribe to the above description, and my GYN is one of those. Fortunately, I don't see him that often. My internist is a family doc, he remembers me, my family, and always has time to ask about personal things. I have been seeing him for eleven years and am so grateful I found him.

8:44PM PDT on Jul 6, 2011

I have a great Dr. She is the best, I would not trade her for anyone else.

4:06PM PDT on Jul 6, 2011

My doctor knows my body almost as much as I do. He treats you like family and listens and finds a cure for everything. This is a great article, bring on part two article. Thanks for the great post.

6:57AM PDT on Jul 6, 2011

That's another good point in favor of concierge medicine....the doctor makes house calls.

My doctor now has the time to study nutrition on the side, and we all know that nutrition has been grossly ignored in med schools and most doctors haven't a clue about nutrition or the dangers of chemical food additives and the interactions they have with medications.
When I'm in the hospital, I can't eat the food because it's so full of chemicals. My husband has to bring me organic food. I can't even drink the juice with additives....and I have such chemical sensitivities that I can't take most meds.
Doctors don't know enough about chemical sensitivities either...and they treat the symptoms caused by one drug, with another drug that will cause new symptoms of its own....leaving a patient feeling worse.

Doctors have to be willing to learn beyond school...just as the rest of us.
It's up to each of us to know our body and participate in our medical care with some responsibility.

6:27AM PDT on Jul 6, 2011

What you are doing is outstanding! You're saying what probably many doctors are thinking but feel too caught up in obligations to change. Our system for producing doctors is twisted and needs to be fixed. Let's just hope that you will not be censored while doing what you're doing!

6:12AM PDT on Jul 6, 2011

My body, my life...........it is my 'right' to ask questions and be my own advocate. I try not to 'waste the drs time' but I do expect answers to my questions and explanations of any treatment....and answers to questions like, "...is this surgery really necessary?" In my long long life, I've had lots and lots of experience with doctors for myself, my children and my Mother. And believe me, their are good doctors and there are those just 'putting in their time'....they are not Gods by any means and should definitely not ignore questions.

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