Saturday, May 01, 2010

Why do doctors treat patients as idiots ?

Painted by Toulouse-Lautrec in the year of his...Image via Wikipedia

Many doctors underestimate their patient's intelligence. The truth is that most patients ( most of the time):
1. want to know as much as possible about their illness and their treatment options
2. are smart enough to understand their options

Patients want to be treated with respect. They look up to their doctor - and trust he will do a good job treating them. So why don't all doctors treat their patients as intelligent adults - someone who is capable of understanding what has gone wrong and what the doctor needs to do to fix the problem ?

Do doctors feel threatened by patients who ask questions ? Or is it that they do not have the time or energy to answer these questions ?

Some well-meaning doctors are worried that patients will not be able to understand the niceties of their medical problems. The nuances of medicine can be subtle, and few answers are black or white. Most are shades of gray, and these doctors are worried that providing additional information will just end up confusing the patient.

Others are not happy about sharing the uncertainty which is inherent in medicine with their patients. They want to be perceived by their patients as being the expert, and this is why they need to provide unequivocal answers. Others are concerned that discussing unclear issues with patients may cause them to lose confidence in the doctor. They believe that patients expect clear-cut answers - and that it's the doctor's job to provide these. Why add to the patient's confusion by talking about ifs and buts and maybes ? Doing so also runs the risk that the patient may end up selecting an option the doctor does not personally like - and this will just add to the tension.

I believe that if the patient cannot understand what the doctor is saying, the fault is the doctor's - he is not doing a good job explaining ! Most patients are quite sophisticated, and are used to handling uncertainty in their daily life. They want a doctor who will discuss their options with them, and provide guidance when asked for, rather than tell them what to do and expect them to blindly follow instructions.

I have found that sharing medical journal articles with patients will often them to come to terms with their disease, and help them to make the right decision for themselves.

Good doctors have a deep understanding of the technical minutiae of their specialty - and while they are capable of doing advanced research and publishing in medical journals, they are also capable of simplifying and explaining all the nitty gritty of their specialty to their patients !

Patients who are treated as idiots tend to behave like idiots !( Of course, sometimes patients do behave like idiots on their own as well , but thankfully this is a small minority !) Patients who are treated with respect will , in turn, respect the doctor and look upto him as a trusted professional , for guidance and wise counsel.

I treat many patients who are CEOs . They are very smart and teach me all the time ( if not about medicine , then about how to run my practise, for example !) If they are bright to run a company, I am sure they are smart enough to understand everything about IVF. Clever doctors will acknowledge the patient's expertise and make use of this !

Doctors need to take a proactive approach and understand that teaching their patients and treating them with respect is a great way of differentiating themselves from the competition.
The web is a great tool for patient education - and the nice thing about developing patient educational modules on the web is that once they have been developed, they can be used many times !

I have found this very rewarding, and you can see some of the patient educational modules we have developed at This is a "proof of concept" - and we hope that other doctors will use this as a model they can emulate !
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1 comment:

  1. Anonymous10:18 AM

    Thank you for writing this.


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