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?