8 thoughts on “The Doctor-Patient Relationship

  1. Maggie-

    The doctor-patient relationship HAS changed from one of paternalism to an adult-adult relationship – key factors contributing to this are higher education levels of patients and the democratization of medical information through the miracle of the internet

    • Dr. Rick–
      I agree that things are changing –but, at least here in Manhattan, many doctors continue to be paternalistic and patronizing.

      Recently, my husband was hit by a car, and fractured his spine. (A small fracture). When they did the C-scan, they noticed something on his thyroid, and suggested that it might be cancer (or might not be). They wanted to do a biopsy. Probably
      the results would be uncertain. Then they would want to operate to remove part of his thyroid. Side effects are common–and there is the risk that they would hit his vocal cords and he would be left unable to speak.
      The doctors (his PCP and the orthopedist) did not mention any of this. I found it on the Mayo Clinic site.
      If I hadn’t intervened they would have pressured him into doing this. He’s a nice person and tends to trust doctors.
      Meanwhile, he has no symptoms. Even if he had thyroid cancer it moves very slowly–much like prostate cancer.
      The Internet can help–but only if you are pretty well educated and have access to the Internet. A great many poor people and middle-class people don’t.

  2. Maggie

    Sorry about the experience with your husband. I’m not an expert but would always be happy to take a call from him or you . Hopefully he is now doing fine?

    You are correct about the internet divide between economic classes

    Rick

  3. Dr. Rick–

    Thanks very, very much. He is still in some pain. The spine will heal, but it will take time.

    He is waiting to get physical therapy. He wants to make sure they will cover it. It is not clear that his Medicare Advantage plan will cover it because it was an accident and he wasn’t hospitalized.

    The driver is lying and saying he never hit him!

    There were no witnesses. My husband was crossing the street, walking in between two parked cars (There was a huge cars-length space between them.) He paused to make sure another car was not coming down the street, and suddenly out of nowhere, the driver in one of the cars (a pick-up truck) backed up on him, very, very fast,
    and very,very hard (major bruise on his thigh), throwing him
    flying up into the air. He landed in the middle of the road, on his back. His glasses wound up on the other side of the road.

    The driver’s back lights weren’t on, and it was dark enough that my husband hadn’t seen that there was someone in the car. Apparently the driver didn’t look in his rear view–just went into reverse, and gunned it.

    He is significantly older than I am (82)–and could have been killed. It’s just lucky that he is in very good shape, and tough. (A first -generation Sicilian from Brooklyn–great gene pool, genes from all over. As one of our friends says, Sicilians are Jews who could swim. Plus Greeks, Nordic conquerors etc.)

    A women came up to my husband to ask if he was okay. She said she hadn’t seen anything–just saw him lying in the road, and didn’t want to be involved. The driver got out of the pick-up, and talked to her. My husband was now on his feet and asked the driver for his phone number and insurance. The driver refused, got in his car, and drove off. (By then he realized there was no witness.)
    Luckily my husband was quick enough to find a scrap of paper and pencil in his pocket and got the license plate. (At that point, I would still have been lying in the road.)

    He then walked to the large grocery store on the corner to see if their outside cameras had picked up the incident.
    They explained, no, they don’t point down that street
    because there is a bank on the other corner, and if there is ever a bank robbery, they wouldn’t want to be involved!

    When my husband’s primary care physician tried to refer him to an orthopedist, the orthopedist told her he wouldn’t see my husband because it was an accident, there could be a lawsuit, and he might be called onto to testify. He wouldn’t be paid enough for his time–it wasn’t worth his while! .
    The PCP found another (woman) orthopedist
    Only in New York City.
    (Or, at least, I hope only in NYC)

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