News flash: Doctors hate our health care system as much as patients! I am going to make a bold, unsubstantiated claim that doctors hate it for different reasons than patients, however. About a month ago I blogged about patients losing trust in their doctors. It is not that I do not trust my doctors. It’s that I worry they have divided loyalties considering nearly three-in-four work for a hospital or a hedge fund. Over the years my doctors have always been good about helping me save money once I explain I am price sensitive and have a high-deductible health plan. I worry the day will come when my doctors can no longer do that. I am concerned that their electronic medical records software will override them when they have not ordered all manner of tests from the hospital lab at prices ten times what I can get on my own. WSJ had this to say:
A recent Turning Points column discussed patients’ eroding trust in doctors, who for better or worse, are the front face of the healthcare system. Readers shared stories of rushed appointments, disjointed care and communication breakdowns.
Doctors responded, and they have trust issues too, including with patients.
Everyone hates the U.S. health care system for distinct reasons. Physicians believe they are blamed for conditions that are beyond their control. Doctors complain they have lost the autonomy to tailor their care to patient needs. For instance, doctors complain about their corporate employers, who expect them to see four patients per hour and require extensive documentation. Doctors also complain that patients often lie to them about when symptoms began, how much they drink, whether they do drugs and whether they are following their treatments. I have often said, at its core, the doctor / patient relationship is an information exchange. When patients provide incorrect information the quality of care suffers. Of course, then the information exchange is cut short due to employer’s requirements, that too can affect the quality of the exchange. Many of these complaints predate covid, but doctors say covid exacerbated the problem.
Doctors also complain patients often have unrealistic expectations.
Some people expect or want an immediate diagnosis and simple resolution, without a lot of medications and surgeries. When that doesn’t happen, they blame the doctor. Doctors recognize a family’s pain and heartache, but feel second guessed.
Bettinger, the gastroenterologist, has in the past responded to unreasonable expectations by saying something like “I don’t have a magic wand,” which he realizes is a mistake. A better response, he says, is “This will take time to sort out,” or “I can’t cure this but I can keep it in remission.”
Doctors also feel like patients are second guessing them.
Increasingly, people are turning to online sources for diagnosis and treatments, which can affect trust. Doctors, for the most part, don’t mind and even encourage people to educate themselves with reputable and research-based online resources.
Years ago, when medical information first began to appear on the Internet, medical journals initially worried about the quality of medical information. Later, what I believe to be physicians’ real concern was related to physician’s time. Doctors worried their patients would arrive at their office with a handful of articles printed from the Internet. Even if the articles were from reputable sources, discussing them would still require physicians’ time. It was undoubtedly easier for doctors back when they were the sole source of health information patients received. Of course, that was not necessarily empowering for patients.
Doctors interviewed by WSJ had a few ideas about how to rebuild trust. One said he now addressed patients by their last name as a sign of respect. Another recommended giving patients their full attention. He encouraged patients to write down their symptoms and prioritize them. That would make physician visits more efficient.
Finally, doctors and patients need to understand that in most cases information is the service being provided. Both doctors and patients need to recognize that. A physician’s time is worth nothing if patients learn nothing. Moreover, doctors can do little without accurate information about symptoms. I remain concerned that my doctor’s advice will (someday) represent what his/her employer wants to sell rather than what I need at a cost I can afford. I want to be my doctor’s patient, not an opportunity to meet this month’s revenue target.
Read more at WSJ: Doctors Are Just as Frustrated as You by Our Messed Up Healthcare System