Friday, September 10, 2010

Doctor power

There are lots of websites which talk about the empowered patient , but there's surprisingly little about the power which the doctor yields.

Part of this is because it's so obvious that the doctor has much more power than the patient in any medical encounter. But what is the source of this power ? and how can it be used ? or misused ?

In his excellent text book, The Doctor's Communication Handbook, Dr Peter Tate talks about three 3 types of doctor power

1. The power which the doctor has because of his medical expertise. He calls this "sapient power". In the past , this was the major reason why patients looked upto doctors . Doctors had access to medical information, which only they could understand - and patients needed to tap into this expertise if they wanted to get better. With the advent of the internet, however, this variable in the power equation has changed dramatically - and many patients are now even better informed than their doctor about their particular medical problem.

2. Social power , or moral power. This is a result of the doctor belonging to the elite medical profession - a guild which controls medical power . Modern society has handed over the social role of the healer to the doctor; and when the patient adopts the sick role, he hands over some of his autonomy to the doctor.

3. Charisma - or the personal power of the doctor. This is an intangible, which varies considerably from doctor to doctor. Some doctors ooze charm; some radiate confidence - while others inspire patients with the length of their retinue ! This is part of the "magic" which a good healer has - something which cannot be easily defined or transmitted.

Patients need to understand the source of the doctor's power, so they know how to make the most of their doctor. Each doctor has a different style - and patients will need to adapt to this - or find another doctor who is more in tune with their needs !

Thus, younger enlightened doctors will share their expertise and try to forge a partnership with their patients. However, not all patients want this additional responsibility ( which also comes with chores and duties). They prefer a more authoritarian doctor who will tell them what to do, so they can follow his orders, and get better sooner, rather than break their head over making complex decisions about things they do not understand ( and would prefer not understanding !)

I do not feel any style is good or bad - they are all different - and they all work for certain doctors and certain patients. The trick is for you to find a doctor who has a style you are comfortable with !

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