Diagnosing a Failed Relationship
The New York Times has been running a series of articles, which amount, more or less, to an autopsy of the doctor-patient relationship. Pretty soon this relationship, perhaps the most important professional relationship of them all, will have nothing to do with either party to it, and everything to do with all the forms that stand, like some Berlin wall, between them. At the breaking up of every relationship, it is inevitable that one person is hurt more than the other, and we should not be surprised that in this case it is the doctor. But, notably, it is the older doctors, the ones leaving their practices in droves, who feel that their profession has suffered a grievous blow. Younger doctors, having entered medicine as the tie was fraying, are used to being dispensaries of drugs rather than of wisdom or advice.
While it would be disingenuous of me to eulogize a relationship I have never experienced (my visits to the doctor somehow never involve one), I can’t help but think that such a relationship would add richness to my life. I imagine it might resemble the relationship an old man has with his barber of fifty years, filled with confidences and trivia. (Again, this is speculative; I entrust my locks to the care of the attractive women at Supercuts). One would think that psychiatry, a branch of medicine that relies on talking and listening, could hardly dispense with either without destroying the profession, but, as this article shows, psychiatrists have nimbly redefined themselves, and thus the profession, by reluctantly giving up their status as sages to become little more than glorified apothecaries, who see their patients chiefly to fill or refill their prescriptions.
The reduction of the authority of doctors comes, of course, at the same time we are all experiencing enlightenment about our own conditions through WebMD and other such websites. No longer are there just three opinions to be reckoned with; there is ours too, and it is the most important. We go to the doctor armed with facts about our ailments. Knowing our time with him is limited, we must say our peace before he can say his. Lawyers, mechanics, carpenters, pest-removers—they do not have to deal, blessed creatures—with our expertise, but doctors, poor souls, must. I am, in general, against immediately deferring to anyone because of his position, but to remove even the predisposition to yield to the experts creates a situation in which doctors have to endure lectures from their patients, amongst other indignities. Professional relationships work because they assume a certain amount of ignorance on the client’s part and an ample amount of expertise on the provider’s. The problem at the moment is that the patient has taken on airs and the doctor has been deflated, leaving them on equal, but hardly reassuring ground.