In my experience as a patient, I concur that most doctors DO judge their patients. Sadly, I believe they make that judgment prior to entering the examination room. The Dr. looks over electronic medical records, they glance over the intake form to see the primary complaint of the patient they are about to see...and then enter the room with a pre-conceived plan of attack to treat that symptom or to which specialist they will send them.
Doctors, these days, rarely take adequate time to get to know their patients. They distance themselves by displaying a lack of patience, compassion and caring - perhaps due to some "patient quota" dictated by a parent medical group administrator. To your point, in order to "take the patient as the person they are", one (the Dr.), must first allow adequate time to listen, communicate and get to know that person.
Listening and compassion wins trust...and that rarely can happen in a 10-minute visit.
I’m sorry that this has been your experience with doctors and the medical system... and I'd wager that this isn’t an uncommon experience. There are definitely opportunities for improvement in our current practice of medicine. With that being said, allow me to clarify a few points:
1) I'm not saying that most doctors judge patients. In fact, while rolling through different specialties during my third year of med school, I found the opposite to be true. Many docs simply wanted to help as best they could.
2) To your point on doctors making judgements prior to entering the exam room – in a primary care setting, when a doc is reading over a new patient’s primary concern, he or she takes into consideration multiple factors regarding a potential diagnosis. These include prevalence of disease in the community, age, sex, and the presenting symptom itself among others. This is part of developing what’s called a differential diagnosis (or differential for short), which is a list of causes of your patient’s problem. Your initial differential should encompass every possible cause of the symptom. And then over the course of interviewing the patient, you shuffle your options around, cull your list, then either (a) make the diagnosis and ascribe a treatment plan or (b) create a diagnostic plan to figure out what’s going on. Does this always happen correctly? No. Do doctors sometimes assume a diagnosis and treat their patient based on what they want them to have? Yes. However, this is not the rule - it’s the exception.
3) To your point on time – you are 100% correct. Time is essential in building a strong, trusting relationship. And, like you said, it’s pretty much impossible in a 10-minute visit. This is one of the reasons for a growing number of docs adopting a direct care model rather than choosing to be employed by a large hospital group. Additionally, there are many docs who buck the system and spend more time with their patients than is “allowed.” These people should be commended.
4) You are spot on with regard to listening and compassion winning trust. It’s my view that in our current medical system, listening is an underrated and underutilized aspect of the therapeutic process.
Thank you for taking the time to comment and for supporting my work! Building better doctor-patient relationships is my main goal with this blog, and that cannot happen without input from patients like you!
In my experience as a patient, I concur that most doctors DO judge their patients. Sadly, I believe they make that judgment prior to entering the examination room. The Dr. looks over electronic medical records, they glance over the intake form to see the primary complaint of the patient they are about to see...and then enter the room with a pre-conceived plan of attack to treat that symptom or to which specialist they will send them.
Doctors, these days, rarely take adequate time to get to know their patients. They distance themselves by displaying a lack of patience, compassion and caring - perhaps due to some "patient quota" dictated by a parent medical group administrator. To your point, in order to "take the patient as the person they are", one (the Dr.), must first allow adequate time to listen, communicate and get to know that person.
Listening and compassion wins trust...and that rarely can happen in a 10-minute visit.
I’m sorry that this has been your experience with doctors and the medical system... and I'd wager that this isn’t an uncommon experience. There are definitely opportunities for improvement in our current practice of medicine. With that being said, allow me to clarify a few points:
1) I'm not saying that most doctors judge patients. In fact, while rolling through different specialties during my third year of med school, I found the opposite to be true. Many docs simply wanted to help as best they could.
2) To your point on doctors making judgements prior to entering the exam room – in a primary care setting, when a doc is reading over a new patient’s primary concern, he or she takes into consideration multiple factors regarding a potential diagnosis. These include prevalence of disease in the community, age, sex, and the presenting symptom itself among others. This is part of developing what’s called a differential diagnosis (or differential for short), which is a list of causes of your patient’s problem. Your initial differential should encompass every possible cause of the symptom. And then over the course of interviewing the patient, you shuffle your options around, cull your list, then either (a) make the diagnosis and ascribe a treatment plan or (b) create a diagnostic plan to figure out what’s going on. Does this always happen correctly? No. Do doctors sometimes assume a diagnosis and treat their patient based on what they want them to have? Yes. However, this is not the rule - it’s the exception.
3) To your point on time – you are 100% correct. Time is essential in building a strong, trusting relationship. And, like you said, it’s pretty much impossible in a 10-minute visit. This is one of the reasons for a growing number of docs adopting a direct care model rather than choosing to be employed by a large hospital group. Additionally, there are many docs who buck the system and spend more time with their patients than is “allowed.” These people should be commended.
4) You are spot on with regard to listening and compassion winning trust. It’s my view that in our current medical system, listening is an underrated and underutilized aspect of the therapeutic process.
Thank you for taking the time to comment and for supporting my work! Building better doctor-patient relationships is my main goal with this blog, and that cannot happen without input from patients like you!
Best –
Tyler