Not too long ago, physicians were far and away the most respected professionals. In a Gallup Poll taken in December, 2008, physicians ranked fourth, behind nurses, pharmacists and high school teachers. Why the drop in respect and admiration? There are many reasons, many of which we are powerless to alter.
With the emergence of HMOs and other managed care organizations, patients have less choice as to who their doctor might be. These choices may change each time an employer renegotiates the contract. When physicians are employed by these organizations, there is tremendous pressure to see as many patients as quickly as possible.
In addition, the public has unreasonable expectations from the medical community. Several times each week excited announcements of the impending cure for some horrible malady or eradication of a dreaded pestilence blare from our TVs and newspapers. I find it interesting to count how many times the qualifiers may, could, might and possibly are used in these breathless reports. They then disappear into some black hole seldom to be heard of again and are replaced in a day or two by the next miracle cure or silver bullet.
Patients now have almost unlimited access to medical information—some accurate, some misleading, and some patently false—via the internet, television, and countless magazines. They can arrive in our offices as well-informed participants in their health care. They can also arrive as simply confused by, or frustratingly unaware of, the limitations of their newly found knowledge.
We can do little to change these things. But we are not without fault. In large measure we have ourselves to blame for our slipping regard and prestige. In many cases we have drifted away from being personable, caring physicians who are our patients’ advocates in order to run more efficient practices and to be technically more proficient practitioners. Somewhere along the way we seem to have lost sight of the idea that the patient comes first. We have forgotten that the disease doesn’t have the patient— the patient has the disease.