Random thoughts

My psychotherapy supervisor is a great teacher, somebody who can draw thoughts out of you that you didn't know existed. Today, I discovered that the idea of being a 'provider' taking care of a 'client' is not a comfortable one. I believe that a doctor patient relationship is much more than a provider-consumer relationship. My patients have a right to make their decisions and to be fully informed, but that does not diminish my responsibility towards them. With the malpractice risks, its more common to see physicians asking patients to take more and more responsibility for tough decisions, even when patients clearly say, 'I don't know. I want you to decide.' I've seen doctors shake their head and say, 'I can't make that decision for you'.

According to Dr. M, my supervisor, our roles change with every stage in life. From being dependent on our parents for every need to being independent to taking care children who are dependent on us. Until we fall sick. Then we regress, and start looking for somebody to take responsibility, and that's where the the physician steps in. While we have moved away from the classic paternal position of the physician, the 'position of greater responsibility', if you will, still lies with the physician. This is the psychodynamic perspective, and it may not work in every situation. But it works for me, no matter which side of the desk I'm on.

What works for you?

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About purplesque

Psychiatrist, cook, bookworm, photographer. Not necessarily in that order.
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6 Responses to Random thoughts

  1. I've seen some doctors say what they would do if it were there grandmother or something, but then they would always add the caveat that it's ultimately up to them. I think some even said that they couldnt make that decision for them… but they still gave their opinion on what they would have done (when the patient specifically asked what they woudl do if it were their sister, aunt, etc) I think most doctors i've worked with usually gave their opinion but left the option open to whatever the patient decided. I think I liked that approach.

  2. Purplesque says:

    I agree..I like that approach too. The patient must have the autonomy to decide, but give them your opinion! Isn't that what experts are for? When I fall sick, I want my doctor telling me, 'This is what is best in my opinion. These are your other options. What would you like to do?' And if I'm making the wrong judgment in his opinion, I want him/her to try and convince me.

  3. Lakshmi says:

    I yearn for the days when each family would have its own "family doctor" who would take complete responsibility for all health-related decisions. I remember the time when the family would be so relieved when the doctor arrived to look at a sick member, because "now that the doctor is here, he will take care of everything". I also remember our family doctor, who now resides with the angels, along with all the senior members of the family, would actually drop in at dinner time and make sure that his patients were eating exactly as he ordered them to. One extra pappad on the plate and all hell would break loose. I believe my grandparents feared Dr. Seshadri more than the God of Death.Where has that breed gone?

  4. It's great you have Dr. M to talk with, etc.Yes, wow — illness changes people..infirmities…the effects of aging, etc.We're children in large bodies, anyway, i think — at our CORE, anyway — and that little kid takes over when we're threatened, if only for a while. And like most terrified kids, we'll take help wherever we can get it. If only for a while.

  5. Purplesque says:

    Oh yes. He still lives on back home, where my mother insists on taking my gastroenterologist sister to see our family doctor when she gets traveler's diarrhea.I wouldn't mind someone like Dr. Seshadri showing up at dinnertime and making me eat healthier. 😀

  6. Purplesque says:

    Yes..and its so important to have someone you trust around at that time. Mom and the family doc who showed me how to put little steel balls in empty capsules to make them stand up..

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