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    Top 10 challenges facing physicians in 2018


    8. Growing patient disrespect toward physicians

    The doctor-patient relationship has changed in recent years. Whereas patients used to follow their doctor’s advice without question,  thanks to the internet and social media patients today often come to the examining room convinced they know what ails them and what should be done about it. Meanwhile, doctors are able to spend less time with patients and thus can’t get to know them as well as they used to.

    Gail Gazelle, MD, FACP, an executive coach for physicians and physician leaders and author of “How to Build Your Resilient Self,” discusses how these trends erode patient respect for physicians and the medical profession, and how doctors can respond.

    Medical Economics: Do patients respect doctors as much as they used to?

    Gail Gazelle: I think a lot has changed. We can all get vast amounts of information about anything. So that divide between physicians and patients has really shifted. There’s an attitude of, ‘How do you know you’re right, doctor?’ People can doubt the wisdom of the medical field. 

    In addition, society has changed. With all our electronic devices, we don’t relate to one another with the same compassion that we might have in the past. And with the corporatization of medicine, doctors have much less time with patients than they used to and many more distractions.


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    ME: How does all this play out in the context of the one-on-one encounter between the patient and the doctor?

    GG: What doctors talk about is the erosion of respect. Part of that’s on the patient’s side, but I think a great deal of it is doctors don’t feel respected by their employer. The doctor in private practice had a lot of autonomy. Now the doctor has become just another employee, and they’re not used to that. So the doctor enters the exam room feeling kind of resentful of all the pressures and not valued.

    ME: Anger can sometimes be the product of discovering how much of a bill you owe. That’s different than no longer taking the doctor’s word as gospel, or respect. Is there anything doctors can do about those?

    GG: I think what’s critical for both the doctor and the patient is basic human respect and compassion. So it behooves the doctor who encounters a hostile patient to realize it’s nothing personal. They need to check that personal reaction and ask, ‘What’s actually going on with this individual that they’re reacting to me in this way?’ Because when we do that, we come to a more compassionate place and have more clarity about what’s going on, what we have to accomplish in the medical encounter.

    ME: Which can be hard to do sometimes, when it’s late in the day, and the doctor has had to deal with lots of other hassles?

    GG: Of course it’s hard to do, but at the end of that long day the doctor will feel a lot better about herself or himself if they have responded this way than if they’ve gotten irritable. What’s going to make you hold your head a little higher at the end of the day? Aligning actions with our personal values, which for most doctors is caring for patients.

    I’m a believer in the power of awareness and shared humanity of any endeavor. And the more we align with that I think we actually build pathways to mutual respect. We all want to be acknowledged and valued and have our basic human dignity appreciated. The more we can treat one another from that perspective I think a lot of these problems will resolve themselves. 

    Find more resources to improve physician-patient communication by visiting bit.ly/18-patient-relations

    Next: Remaining independent 

    Rose Schneider Krivich
    Rose is the content specialist for Medical Economics.
    Todd Shryock
    Todd Shryock, contributing author


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