You look “maaavelous”…on paper…

In my own personal experience, I have come to realize that people don’t care how much you know, but rather, how much you care. This is never more true than in the delivery of health care and the relationships we, as physicians, share with our patients. For instance, I have heard many patients tell me that “such and such” was a good doctor. This is especially true if they enjoy the relationship they have with their doctor. However, I have also heard statements such as “Oh, I didn’t like him or her” or “they just wanted to do ‘this or that’ to me”, and I wonder, what happened in that relationship– if there even was one to begin with.

What makes the difference between okay physicians, good physicians, and great physicians? Certainly it can’t be the diplomas or awards hanging on your office wall. Sure, they’re great decorative pieces and add to the flair of your office, especially if you’ve framed them nicely. However, most patients I know, never even once asked me where I went to undergraduate school. I sometimes get a few questions about where I went to medical school, but rarely does that impress or reflect upon the quality of the relationship I have with that person.

What does really matter is that patients are human beings. To show patients that they are more than just numbers on a laboratory print out each time they come in is, on many levels, reassuring to patients. I have seen a lot of “good looking” people on paper; but when they come into the office, they’re miserable or lacking in health. What I am discovering nowadays is the decline of the patient as a real person and more a categorizing of such persons as “consumers” or “numerical values”.

This is now the dilemma as we see a push from “relational” medicine to “performance-based” medicine. Most of this change is forced upon us by insurance companies who have largely ruined our relationships with patients by telling us that we must see a certain “quota” of patients per hour, how to bill, and/or how to prescribe medications for our patients (a terribly humiliating and frustrating experience for most educated physicians who have ever had to do a prior-authorization).

Most of the time, we, as physicians, have just accepted our passive role in this macrocosm, because, at the end of the day, we have to make a living somehow. But what is transpiring is rapid movement towards treating numbers rather than patients; treating labs more than the human being. This trend will eventually ruin and dissatisfy most people because they will be diminished to nothing more than just numerical values on a piece of paper.

But what patients want the most is an intelligent relationship with their physician. They want to be able to make a choice in their health. They want to experience a partnership with their physicians. This is why medicine is not only a science, but an art-form. Most physicians today seem to have forgotten about the art of medicine because they are hard-pressed to practice the science of medicine more often; in essence, number games.

Building quality relationships with people allows the leeway to open doors of compliance and change with people. Telling people they will die because they don’t do what you say is “old school”. If you want your patients to make intelligent decisions, empower them to think about the consequences of their decisions on their own. The process of giving people the ability to make decisions regarding their health is only humanistic in approach. The unfortunate thing I see happening is that physician-patient relationships are becoming sacrificed in the name of performance-based medicine. Sure, people will look great on paper, but will they actually be any healthier? Will they actually feel any better just because we drive their cholesterol down with a medication, while they are still obese and suffering from chronic back pain or degenerative arthritis of the knees or hips?

I’m sure we’ll all rest comfortably at night knowing that “at least I did my job today…my patients look great on paper!” The consumeristic and commercialistic mentality that we call health care delivery has got to change. Let’s turn the whole thing around and change the way we care for our patients, who are, after all, no less human than you or I.