Wednesday, March 12, 2008
Patient Expectations
As I've mentioned, I've worked in a hospital for a year. My understanding of the medical system has been greatly affected by this exposure, so that it seems completely self-evident to me that doctors don't always have the answers, or aren't always right. My grandmother is from the old-school "the doctor knows best" ideology. I suspect that most people fall somewhere between these views, so I'm curious to know: as patients, what are your expectations of doctors, other health care professionals, and the health care system? How have your expectations changed as you've learned more about how the system works and what sorts of challenges doctors face?
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3 comments:
I think all of us want to believe the ideology of "the doctor knows best", because it does make things simpler and much less confusing. Especially when it comes to complicated issues on health care. I think I do at least. I think most people have an expectation that doctors do know everything, because they are an authority figure, and it is their "job", so to say, to know these things. But realistically speaking, I think our views are a little high, especially after what we learned in class. One of the studies in my research group that I was part of last year (though I didn't do this specific study) looked into how doctors (specializing in cardiovascular diseases) processed risk and how often they did it. What they found was that the more experienced the doctor, the more often they will take risks because they believe that they do know more than someone with lesser experience. This therefore increases the chances of incidences of mistakes in diagnosis and treatment processes. The health care system isn’t perfect, nor do doctors know everything… but as individuals in a society where doctors are our authority figures in the realm of health care, the ideology of “the doctor knows best” can never really be ignored.
I think that both experience and knowledge is what creates peoples expectations of health care providers. Something that sticks out in my mind is an experience I had over the summer at my internship. I interned on an inpatient schizophrenia unit; the model of treatment that this particular unit was based on was one that had to be consistent and concise so as not to confuses the patients in the process of their treatment (this was important given that in this case, the patients are in the throws of an illness that alters their perception of reality and in turn makes them less able to make autonomous decisions regarding their treatment). While I mostly witnessed consistent and proper enforcement of the treatment protocols by the staff, certain staff members were not so apt with this and I felt as though it irresponsible (especially since, as I mentioned before, the particular group of patients were very vulnerable and in need of proper direction to ensure effective treatment)—it surprised me since this was at a pretty reputable facility. I guess my main point is that after getting an “inside look” at some of the shortcomings of care for such a serious illness at such a reputable place, it’s made me more wary of the concept of “doctor [or any health care worker who’s supposed to be trained in their given field] knows best”.
The way I see it, a doctor tries to know best, but at the end of the day, he or she is just like me: human. They have relapses of judgement, as well as logic. Although, I have noticed I do trust the doctor more or less depending on my state of mind. When it is something I deem serious (and I am weak and vulnerable like after fracturing my right ankle), then I think "the doctor knows best;" however, when I'm less worried and think I know what is going on, I trust him/her less if the diagnosis is contrary to my own diagnosis. So my expectations of health care professionals are, unfortunately, strongly influenced by how I feel at the moment.
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