“Doctors are next only to god.” This was a fairly common statement since maybe before Hippocrates, till recent past. Many of us have, especially surgeons, I daresay, have heard this expression in our Government almamaters. But now, news of doctors being assaulted is fairly usual.So what exactly happened – did God go rogue or did people stop believing him? I would say – both.
When I say recent past, I mean before the era of internet information, corporatization of healthcare and before the death of trust in general. In this age of Google, it is but natural to ask it about the disease and its treatment, being well aware of the abundance of unregulated and often inaccurate information it may fetch. It is good for basic understanding, but may make the trust in best doctors quite ‘tentative’ and the ‘E-patient’ skeptical at each step of treatment, which is actually counterproductive. The next most important thing is the whopping rise in healthcare cost. The imbibition of world class healthcare along with Evidence-based treatment protocols is most likely the cause and it makes the corporate healthcare unaffordable by many. This is compounded by a low spending norm on health in developing countries and less penetration per capita of health insurance. The final outcome is a trust decay that has significant implications on treatment outcome. A sound doctor-patient relationship is shown to have a positive effect on final treatment outcome, patient is more likely to complete the treatment and to adhere to follow-up advice. Trust building has bilateral influence. Apart from the above mentioned factors, it depends on the patient’s understanding of the disease as well as the communication efficacy of the doctor. Literature shows significantly better treatment outcome by physicians formally trained in medical communication. Therefore, to stabilize the keystone of trust in the doctor-patient relationship, the patients needs to balance the medical advice with the external information. At the same time, the doctor would be helped by a formal training in communication with patients. A step forward in this regards, would be a formal test of communications skills as a part on medical examinations as in western examinations like Membership of Royal Colleges in UK.
Written By: Dr Anupam Saha
