Introduction:
In the realm of healthcare, the patient-physician relationship is a cornerstone for effective medical care. Developing trust and maintaining credibility are vital to this relationship. However, it is unfortunate that patients frequently find themselves struggling to maintain trust with their physicians, ultimately leading to an erosion of credibility. This article aims to shed light on the factors that contribute to the loss of credibility in patients and how these challenges can be addressed.
- Miscommunication and Lack of Information:
One of the key reasons patients lose credibility with their physicians is miscommunication. Inability to clearly articulate symptoms or medical history, or perhaps even disregarding the importance of sharing certain information, can impede accurate diagnosis and treatment. Patients must actively contribute to the dialogue by expressing their concerns and providing relevant details. In turn, physicians need to create a safe and non-judgmental environment that encourages open communication.
- Non-adherence to Treatment Plans:
Patients often lose credibility when they fail to follow their prescribed medications or treatment plans. This can occur due to various reasons such as forgetfulness, financial constraints, or misunderstanding the importance of the treatment. Physicians rely on patients to adhere to prescribed regimens in order to achieve desired health outcomes. It is crucial for patients to communicate any obstacles they face, allowing physicians to work collaboratively towards alternative solutions.
- Inconsistency in Lifestyle Choices:
Lifestyle choices greatly impact an individual’s overall wellbeing. Physicians often assess their patients’ credibility based on their lifestyle habits such as smoking, alcohol consumption, diet, and exercise. Patients who consistently engage in unhealthy behavior may raise suspicions regarding their commitment to improving their health. It is vital for patients to demonstrate a willingness to make positive lifestyle changes and actively engage in managing their well-being.
- Seeking Multiple Opinions and Self-Diagnosis:
Patients who frequent multiple healthcare providers without clear justification may be viewed with skepticism by their physicians. Self-diagnosis through the internet may lead patients to arrive at erroneous conclusions, leading to misunderstandings and potential credibility issues. It is advisable for patients to trust their physicians as the main source of medical advice, seeking multiple opinions only for genuine second opinions or in complex cases.
- Attitude and Demeanor:
Patients sometimes lose credibility with their physicians due to their attitude and demeanor. Displaying hostility or a lack of respect during appointments can damage the patient-physician relationship. Physicians appreciate when patients participate actively in their care and value an atmosphere of mutual respect. Open dialogue, active listening, and being receptive to the physician’s guidance can help repair and strengthen this trust.
Conclusion:
Maintaining credibility within the patient-physician relationship is a two-way street, necessitating active participation and trust from both parties. Patients must strive to communicate openly, adhere to treatment plans, make positive lifestyle choices, and respect their physicians’ expertise. On the other hand, physicians should cultivate a non-judgmental atmosphere, encourage patients’ participation, and make efforts to better understand their patients’ perspectives. By acknowledging and addressing these challenges, both patients and physicians can work together towards building stronger and more credible healthcare partnerships.
Your conclusion is correct, we need to always take a nonjudgmental stance.
That said, and in the interest of dialogue, all your points can be said to be judgmental.
I understand that the therapist’s motto, and that should be the physician’s motto, is “Nothing that is human is foreign” -Terrence
Through my years of trying to do a holistic medicine, including psychotherapy, I’ve learned what I think we all know. And that is we know very little about our patients.
We know very little about their
Over the years, I came to realize it was interesting that in medical school or residency, there’s no teaching or even discussion of how to deal with the intellectual capacity of our patients. It is never actually talked about that we are charged with doing an IQ exam within the first minute of a visit when we have very little skill in doing that.
These deep issues have much to do with why the system has become broken and has taken a reductionist and specialist tact for so long. Unconsciously or consciously people choose specialties because they realize the complexity of the situation and don’t want to deal with it. Often this is a conscious decision. I’ve had doctors say they can’t deal with people so they go into pathology.
The uniqueness of that shame in each of us:
1-the need to see a doctor is humiliating and shaming for many people.
2-having a problem being sick is shaming and humiliating for people.
3-so many people view the doctor, with a sense of awe and respect that it is humiliating to them. “ Why can’t I be like him or her?”
The reason people lie and deceive is because of shame. You may disagree, but ultimately if you trace it back and back and back it’s because they’ve been humiliated or shamed. They feel shame about something.
I remember an old study in primary care. They gave all comers in primary care waiting rooms a questionnaire. The questionnaire was based on asking the patient if they had done anything to impede their care from the last visit.
Such as: Did you consciously skip your medicine? Did you consciously not exercise? Did you consciously not change your bandages? Or did you “forget” to do this for that?
The point is human beings are driven by all kinds of undercurrents of self-sabotage and punishment. So we can add to the list people not communicating or not being compliant or any of the other things mentioned due to their psychological makeup.
Those psychological needs are part and parcel of the whole package you can’t, disregard them and just expect the patient to be “cooperative” and/or helpful because that’s not where their subconscious agenda is.
As HOUSE famously said, “All patients lie.”
As a previous comment noted, it’s all about time and we don’t have time. I have a style of practice focused on time, but I am privileged because I chose this path early on and didn’t worry about the money. I spend an hour with my patients. And I see them once a month. And that certainly isn’t enough time.
I’ve also found as I’ve gotten older that the task when a patient walks in and you begin to take the history you begin to see many different directions you could take. So the task becomes a bit more difficult as early on you think “Oh there’s a chief complaint and I’ll take care of that” but it turns out not to work that way or shouldn’t work that way.
It is also well documented, as far as I know, that people often, especially in primary care, will come to you just to speak to anyone or that is loneliness or because they’ve been abused or because they have trouble with their identity that they’ve never talked about. Yet they can’t bring themselves to talk to anybody so they may come and say they have a sore throat when they don’t or they wait until they have a sore throat  and come to see you hoping that magically there will be a breakthrough but they don’t tell you.
The bottom line is I have learned that the interest we give to our patients, the focus, is the most healing thing we can do. Someone said, “Interest makes the possible, possible.”
For me, there is never a credibility problem with a patient. Even if they’re lying, cheating, or stealing from you all those things are a symptom. They are a symptom of illness that hopefully can be addressed somehow. Certainly, there are limits and you have to just say I can’t take care of this person., my thoughts
We have a difficult job.
Thanks for the thought-provoking post.
I know you’re on the pain patients’’ “side”, but I have to say that #1, #2 & #5 apply to my doctor and Kaiser: I’ve been lied to for a decade now. And when they force-tapered me this year, they literally lied about the reason. This is all coming from them, not me.