Patient doctor professional relationships are important for both the patient and doctor alike, but how do we as patients really see our doctors?
As a child in the 1950s I was always ill and being taken to the family doctor by my Mother. I became used to attending morning surgery. The receptionist I remember would say to my Mother, Oh its little Brian to see doctor again and she would reply yes. Take a seat and I will call you when is your turn. The waiting room was always full even though we were at the surgery by 8am and often I was the only child. Quiet was the word as no one spoke, just sat waiting their turn to see the doctor. Te doctor would appear later and everyone knew when he arrived as he went into the reception to ask how many patients there were and look at the cardex cards. Everything was hand written in those days on small cards. The wait was often long and when was our turn the receptionist ushered us though to the doctor’s surgery cabinet. A small room I remember, but clean and with good light from the window.
Always the doctor would fully examine me and I remember the stethoscopes were cold as hell! The doctor as an old man and would speak loudly to me when examining, Breath in, breath out, hold your breath and so on when examining my chest. He would then say get dressed and would sit down and speak with my Mother. Bronchial problems again, I suffered with them a lot as a child. The doctor would ask Mother about the food she gave me and if we had enough coal for the fire to heat the house, plus I remember one time he asked if I had winter boots and socks and so on. He was never in a hurry and gave my Mother many times advice on subjects relating to my health. My Mother would talk openly with the doctor as well and had confidence in him all of which helped. At the end he would write a prescription for medication and we would thank the doctor and leave. Maybe we were 45-50 minutes in his consulting room with the doctor as were no limits by the authorities on patient/doctor surgery time in those days. It was the same for all the other patients and the doctor would stay long after the surgery hours were over to see the last sick one.
I remember one night and it was after dark that I became very ill, could hardly breath and Mother asked the woman over the road to run down the street to the old payphone to call the doctor. He arrived not long after, spoke with Mother, examined me on my bed and gave some injection, plus then stayed for ages to see the injections were taking effect. On leaving he told Mother that the nurse would call next morning and she did.
Clearly the doctor/patient professional relationship in my case as a child was excellent. I saw him as an old man and one who spoke loudly to me, but was also a kind one and one who made me well again.
I therefore ask this question even though now I have lived in Romania for many years. What happened in patient/doctor relationships all these years later?
How we see our doctors and how they see us.
The first place it must be said that millions of people don’t bother to even go to their family doctor, not even for an occasional medical check up. In the second place it is true that if they did then the doctor would not have enough time to see all of his patients even if the doctor worked 24 hours a day 7 days a week!
Budget cuts in the health service along with many other restrictive management practices have seen a massive reduction in doctor of all grades and not only in Romania but across Europe too. Doctors now move Country to were are better conditions, not only salary, but working hours and were are higher living conditions for them and their families. The doctors left in Country are highly trained experts in their own field of medicine no matter weather a family doctor or hospital specialist, but there are simply too few of them! Funds are also always low for healthcare with lists of medication that can be prescribed changed several times a year. Millions simply cannot afford medical insurance and fear being ill as are too poor to pay the medical bills.
Imagine you are poor and ill, you attend the family doctor and after examination you’re given a prescription for medication to take to the pharmacy. What do you do, well like most you are ashamed to explain you can’t afford the treatment and the doctor is often too busy with so many patients that morning to ask, so you take the prescription and it simply never gets to the pharmacy, rather is torn up and binned. Add to this factor that many doctors travel to the area they work in from towns and don’t know the conditions the patients live in. Unlike the old times when the family doctor lived in the village and knew everyone and it makes a difference. Here we see how patient/doctor relationships have broken down and don’t think you can blame either side, but can blame a system that has been created that doesn’t favor the sick in many cases!
How many times I see public appeals for funds to save the most precious thing we have, being a human life. These appeals can range from a few thousand Euro to hundreds of thousands of euro. They are appeals for life saving surgery/treatment for a person struck down by serious illness and the specialist treatment is more often than not required to be undertaken abroad adding many extra costs. What happened in healthcare I ask? Ah say the authorities there is no funding. Ah say I, but there is funding for non essential projects that few benefit from costing all many thousands of Euro! It doesn’t apply just to the state sector either in my view this intransigence to help save a life, as some of the Worlds most wealthy citizens have a part to play also, but prefer not to be involved. Many are rich people who do support philanthropically and support several causes, but what a difference it would make if they jointly provided a fund to meet lifesaving cases and enticed the state to participate as well instead of looking the other way when a life is in grave danger of being lost. Doctors and medical specialist do a wonderful job, but are hampered daily by restrictions including the likes of what I mention above. Imagine being a doctor, you can save your patient if a certain drug is prescribed, but the authorities don’t have this drug and you as a doctor are regulated by strict guidelines.
On the patient side is also a new distraction and it’s a dangerous method of self diagnosis made often by young people who trawl the internet which is now full of miraculous cures for all types of illness. Medical doctors study many years in their chosen field and are the only ones able to diagnose and cure illness, not Internet quacks as I call them. On another score in the time it takes a person to search the internet for her/his illness and take non medically approved advice, they could in this time have see a real doctor at the local clinic!
Of those who do, when ill go to the doctor it must always be remembered that the doctor is not a mind reader. In other words if you do not explain all of your problems regarding your illness then the medic will find it harder to treat. I know a woman who became ill, went to the doctor and explained she had a cold; she received some medication, but became more ill and when it all appeared this lady had pneumonia. The doctor was surprised when a relative said, ah well she stays outside daily in the cold preparing animal food and doing small jobs in her yard despite the cold and hasn’t a jacket on. This was a classic case of failing to speak fully about your circumstances to the doctor. Just because the doctor is busy doesn’t mean he isn’t listening to you and taking on board what you say! A solid punctual 2 way conversation with the doctor is the way to really help yourself overcome your illness.
As for me I preferred the health system when I was a child, when doctors themselves had time to breathe!!
By
Brian Douglas
(UK & Romania)