The Patient-Doctor Relationship And Self-Care

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Self-Care Tip – Explore self-care in ways where you do have choice, including healthy alliances with your connections.

PattyAnne came in knowing what she wanted.  She was sure she was struggling with ADHD because she could not focus, she had difficulty connecting with others and she was impulsive.  This was limiting her intimacy and ability to love and be loved by the people she wanted in her life.  PattyAnne had read about ADHD and was relieved thinking that taking a stimulant would improve her that much.

Getting ADHD as a diagnosis would explain to the people she would hurt why she hurt them.  It would give PattyAnne a name for the chaos that followed her or preceded her – she could not tell which.  Having a diagnosis that comes from a figure of perceived authority, say a Doctor of Medicine, offers this.  It is much like a judge who pronounces us innocent and another guilty.  This is not a bad or good motive.  It just is.  It is natural, as far as I can tell, to want to get away from implied or direct negatively perceived labels.

As a practitioner, it is not that easy to resist the lure of treatment when it would be so easy to make our patient happy.  It also takes a lot more time in patient education and building a trust relationship if we don’t agree with the patient’s self-diagnosis.  These pressures are real for any practitioner and many have wondered if the frequency of prescribing is affected by it.  For example, it is estimated that 73% of doctor visits for sore throats result in antibiotic prescriptions, but over 90% of sore throats do not respond to antibiotics.   (I know.  That is robbery!  Those poor other patients who got nothing for their copays!  Not even a prescription!)

So in comes PattyAnne, diagnosis and treatment already in place, all she thinks she needs is my signature.  It is not easy to be a patient.  Being a patient is a hard job in fact.  It requires at least some insight or the ability to receive insight, a vulnerable pose, humility, courage, self-respect and so much more.  Maybe PattyAnne was thinking, “Oh boy.  Now I got this woman who does not know that I’m ADHD!”

We have each other and begin the adventure of doctor-patient relationship, an alliance and a connection.

Questions:   What does a doctor-patient relationship mean to you?  How do you see your involvement in choice and control inside of it?  Please tell me your story.


26 thoughts on “The Patient-Doctor Relationship And Self-Care

  1. One of the biggest probelms in medicine today is the internet itself. Everyone seems to be an expert on their own health. The truth about medicine at its core is that it is science plain and simple.

  2. If only the online sites we google to self diagnose could dispense prescritptions….wouldn’t we all be in trouble?!!!!!! Sometimes my self diagnosis are correct sometimes I am WAY off!

  3. When I visit my gen. doctor I feel almost responsible for giving them some sort of self-diagnoses. It would seem to be the quickest way to get to the “cure”.

    • what a perspective! very good to have. thank u.
      yes patients do try to be “good” patients to please their doctors too, as mentioned familiarly that physicians try to please their patients. reminds me of that “The Gift of the Magi” short story written by O. Henry, where “he” sold his watch and “she” sold her hair. thank u kristy for this insight. keep on.

  4. Patient/doctor relationship? The first thing my regular doctor(30 years) says when I go is is “You’re still alive?” The shrink saws “So tell me, what did you screw up on this week?” The dentist smiles as he twirls this pick thing like a little baton and my ophthalmologist is half blind. I call the dermatologist Dr. Itchy and the cardiologists says I’m just a heart beat away from another one.

  5. I think it’s good for people to educate themselves on health and wellness. I don’t go to doctors much, but when I do I expect that we will work in partnership. I know my body best after all, and a combination of that knowledge and a doctor’s ability in diagnosing seems like a very good thing.

    Thank you for posting that statistic about sore throats and antibiotics. I’ve been on my soapbox for years telling people that. Everyone wants a magic cure. I can’t remember the last time any of us in my home took an antibiotic. I wish more people understood that there is a downside to every drug and that if you don’t really need it, you shouldn’t be taking it. (Nor should a doctor be prescribing it.)

    Okay, putting soapbox away now. 🙂

  6. I had a naturopath explain to me once, that most people go to doctors looking for a pill to fix things, and generally aren’t willing to make life style changes to improve their health. He said if I just told my doctor up front, that I’m not looking for a magic pill, but am willing to make changes to improve my health and just need to know what’s wrong, that they’d be willing to work with me. I get the impression, though, that they think I’m some sort of health fanatic when I do this.

  7. I need to trust a doctor and, until I had a breakdown, I did. Suddenly, I was seeing so many doctors – in the emergency room, in the psych ward, in a hospital room, in therapy; for reactions to meds, for tests for everything that might present like fibromyalgia, for other meds, for psychiatric help, for physical therapy – I was so overwhelmed that I literally ended up trusting no one, except for the one doctor I trusted to begin with. Was it because I was THAT sick? Was it because I reacted to ANY medication? Was it that I was THAT scared? I don’t know. I do know that I STILL need to trust a doctor but I also know that I need to trust myself and my body. The doctors I see now allow me to do that. They allow me go at my own pace. They allow me to be a part of the thinking and planning and deciding. They respect me…or at least they seem to. Or maybe I trust and respect myself now. Whatever. Trust. Respect. Going both ways. That’s what a good doctor/patient relationship is, I have found…at least for me.

  8. my doctor kind of gave up on me and sent me to the theropist and he and siad i expectt high things form theropy are but and there is big but now he siad he had high expectation so i thought great cure cure or i would be a lot better not going to happen i am hurt off this very hurt maybe i am a little bit more sick then i wanted to belive and my doctor made me feel this way now i have to recap as well he did say i would not need this blog mutch more after going to the theropist dashed again now i didnt belive him on the last one and i fell apart over the last few weeks who is here now not the theropist not the doctor but the blog to witch i have connected to now then i now feel my doctor is uncapable of not hurtung me or makeing me suffor he has in a way lost my trust or and he stoped seeing me once i had my theropist once a fortnight by just seeing him once a forbight or a mounth i was getting reasurnce i have missed two appointments weith him now as well 3rd time lucky now he is going to get the full force of my head and how i am feeling to how he has managed me or not i am going to say quite a bit on firday my theropist siad in intrest i would rather overdose than see him thats not quite true im lossing him to he is relaceing himself with a cpn the question i now have for him is where do you now see me in a years time why didnt i allready have a cpn what are you going to do now you have let me down or and do you think i should be working or not in intrest my mp says they didnt think i should be on jobseekrs as such or if that was the right benerfit citezens advice didnt think so the jb centre dont think so i think its more inportant at the monment to fix myslef and armour myself for the future rather than looking for work but i dont know im not a doctor at the same time i want to be seen as looking for work becuase i dont want to be seen as sick totle i just want a few exceptions to be made if they can be my doctor at the moment as well trained as he is and as mutch knolldge as he has i dont think he has the knolledge to fix well see what happens on friday one thing that bothers me and i willl feel guilty of is it really my place to challange his judgement or his deccisions

    • I know Sana would say this, too, but I’m SO glad you came back to this blog, Kevin. I don’t know you, except for your writing here, but I have been worried about you. Know we’ll all be thinking of you on Friday and wishing you the very best.

      • sometimes when you want to do something you cant do it and you need to come back to reality i have done well for seven mouth and i am proud of that i have learnt a lot off this site and the conversations off people its such a caring and positive blog and speeks a lot of truths where else where would not either be accepted or not understood and that is why i connect so well to it

        • i was on facebook and having a diccusion about support they were amazed at how theropists and phycyatrists kinda dont like people with BPD and i siad to her the only people and person that has supported me the last few mounth is sana and her blog buddys and you know i havent siad thankyou to everone so thanks everone or and thanks nancy for your comment

          • this is so kind and generous kevin. of course u r welcome and i hope nancy makes her own response because she can definitely hold her own. and thank u for really engaging w us. that is such a compliment. keep on mr. connected.

  9. Your question has baffled me. I really don’t know how to answer but generally, I think the patient needs to trust their physician. The physician should be understanding of the patient’s situation but also make ethical decisions that they know are best for the patient. The funny thing is that earlier today I was looking into the classes I need to take for this summer and in the course catalog of the class I am supposed to take listed the doctor-patient relationship as an area of study. Hopefully I will learn more about the doctor-patient relationship in the class and be able to better answer this question in the future with a different opinion. 🙂

    • jennifer, that’s awesome. please tell us about what u learn. (btw, u don’t sound baffled – “The physician should be understanding of the patient’s situation but also make ethical decisions that they know are best for the patient.”) thank u for commenting w this clear effort and heart.

  10. The Dr/pt relationship should definitely be one of partnership. If it isn’t or if the Dr disrespects you, you should find another Dr. Drive the distance. pay the price or do whatever needed to feel trust and partnership with your Dr.

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