Patient Engagement

Outraged, engaged patient takes aim at paternalistic physician

Duncan Cross, a longtime engaged patient with Crohn's disease, unloaded on a "doctor who pissed me off."

Paternalistic physicians, your centuries-long reign is coming to an end.

It’s hard to know how many patients out there are truly “empowered,” and I suspect it is a relatively small number, but one of the louder voices out there is Duncan Cross, a longtime engaged patient with Crohn’s disease. Last week on his blog, Cross unloaded on a “doctor who pissed me off.”

Cross said his regular gastroenterologist retired, and he had a bad experience with the physician the practice recommended as a replacement. “She was mean,” Cross said, explaining the letter he sent to that new doctor.

It sounded like an adversarial encounter from the start. “I want to apologize for my demeanor at our appointment last Thursday. I have some anxiety issues with respect to physicians, and they were in full force that day. I probably seemed defensive and upset, and I know that is not conducive to a good patient-physician relationship,” Cross wrote.

Indeed, sick people are vulnerable, defensive and upset. It’s impossible to know from reading the letter if Cross set the physician off, but the physician seemed decidedly old-school. “You were treating a disease, not a person,” Cross said. She apparently downplayed his complaint of pain, taking Cross in his mind back to a time when he was suicidal.

This paragraph says it all:

I have been sick long enough to remember when physicians could do that freely — but those days are over. The prejudice that allowed physicians to lord over their patients is no longer excusable. So your attitude was a shock — like finding segregated lunch counters — and I did not know how to respond. I am sure you feel proud of the hard work that got you into that room, but keep in mind that what you endured is not a fraction of what I had to go through to get there. That you had trouble recognizing that fact was baffling and infuriating.

Physicians, you are smart people. You spent a long time training in the art of medicine, and many of you save lives on a daily basis. However, you aren’t omniscient. In fact, medical error has been called the third-leading cause of death in America.

“If you wish to be helpful in your practice, you must learn to regard those patients as partners and equals in their care. Until you do, you will never be able to really help them — and you may well hurt them,” Cross concluded.

Photo: Seattle Municipal Archives via Flickr Creative Commons