You And Your Doctor
What Patients Think Of Their Doctors: The Results Of A Special Survey
Subscribers to Dr Vernon Coleman's Health Letter were asked to give their views on their relationship with their doctor. The results of this survey are based on the replies received from 1144 subscribers. Click here for the results.
Only one in twenty patients trust their doctor all the time.
Most patients don’t
believe that what they tell their doctor will be treated as confidential. Most
doctors never prescribe anything other than drugs, surgery or radiotherapy.
Nearly half of all patients still complain that their doctor hurries them up
and doesn’t spend enough time with them. And most patients who think that
their relationship with their doctor has changed over the years believe that
it has changed for the worse.
What an indictment
of the medical profession. These results make sorry reading – both for
patients and for doctors.
The relationship
between doctors and patients has deteriorated badly in recent decades. And judging
by the results of this survey there isn’t much chance that things are likely
to get any better in the near future.
For many patients
this survey will simply provide confirmation of their own privately held feelings.
For doctors practising orthodox medicine this survey should sound as an alarm
bell.
Doctors have lost
touch with their patients’ needs and feelings. If they don’t make
some real effort to strengthen the doctor-patient relationship, and to provide
their patients with what they want and need, the orthodox medical profession
will find itself being pushed more and more to the fringes of health care. The
traditional role of doctors as primary health care provider will be usurped
as alternative and complementary practitioners prove themselves to be more in
tune with the needs of the modern patient.
Below are the results of the survey together with, where appropriate, my comments.
Question 1:
Do you trust your doctor?
a) all of the time
5%
b) most of the time 39%
c) some of the time 38%
d) hardly ever 14%
e) never 4%
Comment
I found it appalling to discover that today more people never or hardly ever
trust their doctor than trust him/her all the time. In the bad old days, before
progress became the watchword, this question would have been irrelevant and
unnecessary. Everyone trusted their doctor all the time.
Question 2:
Has your doctor ever recommended a form of treatment that does not involve drugs,
surgery or radiotherapy?
a) yes – if
so what 24%
b) no 76%
Comment
I was horrified by the results of this question. Despite all the evidence showing
the significance of so called ‘alternative’ or ‘complementary’
approaches to medicine three quarters of doctors never recommend anything other
than drugs, surgery or radiotherapy.
A special prize should go to the doctor who recommended Fisherman’s Friend lozenges to his patient.
Question 3:
Do you believe that everything you tell your doctor will be kept completely
confidential?
a) yes 44%
b) no 56%
Comment
Once again the result here is startling – and very alarming for the medical
profession. Confidentiality is crucial to the doctor patient relationship. If
patients do not trust their doctor they won’t give him/her the information
he/she needs in order to make an accurate diagnosis.
Question 4:
If your regular doctor was unavailable would you prefer to see:
a) a doctor under
30 11%
b) a doctor over 30 55%
c) don’t care 34%
Comment
I wasn’t at all surprised by this result. I frequently receive letters
from readers complaining about their doctor passing them on to a doctor who
doesn’t seem old enough to have finished his/her apprenticeship. The result
of this question suggests to me that most patients regard experience (and the
sense of clinical intuition which comes with it) as more valuable than fresh,
up-to-date academic learning.
Question 5:
If your regular doctor was unavailable would you prefer to see:
a) a male doctor
19%
b) a female doctor 25%
c) don’t care 56%
Comment
Most of those who expressed a preference said they would prefer to see a doctor
of the same sex as themselves. But most patients are clearly looking for other
qualities – rather than the sex of the doctor they see. The authorities
in many countries have put an enormous amount of money and effort into recruiting
more female medical students – often forcing medical schools to accept
women who are poorer candidates, and who have lower academic standards, in order
to maintain the required quotas. It seems that as far as patients are concerned
this positive discrimination policy has been a mistake.
Question 6:
If your regular doctor was unavailable would you prefer to see:
a) a doctor of
same nationality 58%
b) a doctor with different nationality 31%
c) don’t care 39%
Comment
No surprises here. And yet in many parts of the world (and nowhere is this more
true than parts of the UK) it is rare indeed for a patient to be able to find
a doctor with the same cultural background. This is not a question of racism.
It is a question of understanding.
Question 7:
Have you ever asked your doctor for a second opinion?
a) yes (go to Q8)
26%
b) no (go to Q9) 74%
Question 8:
If you answered yes to question 7, was his response:
a) helpful 54%
b) unhelpful 46%
Comment
I’m less impressed by the fact that 54% of doctors were helpful than by
the appalling fact that 46% per cent were not.
Question 9:
Would you be frightened to ask your doctor for a second opinion?
a) yes 30%
b) no 70%
Comment
Isn’t it alarming to know that nearly one in three patients would be too frightened to ask their doctor for a second opinion? What ogres there seem to be sitting in modern health clinics.
Question 10:
Do you feel your doctor:
a) spends plenty
of time with you 54%
b) hurries you up too much 46%
Comment
Patients have for years complained that they are hurried too much by their doctor.
It seems that things aren’t getting any better.
Question 11:
Has your relationship with your doctor changed over the years?
a) yes (go to Q12)
45%
b) no (go to Q13) 55%
Question 12:
If it has changed has it changed:
a) for the better
37%
b) for worse 63%
Comment
Doctors’ trade union representatives should be concerned with the results
of this question. Instead of threatening to resign and go on strike for more
money and better conditions doctors might be wise to put a little more effort
into finding out precisely why their relationship with patients has deteriorated
so badly in recent years. And then doing something about it.
Question 13:
Do you think of your doctor as a friend?
a) yes 28%
b) no 72%
When I first went into practice (rather a long time ago I fear) doctors (particularly general practitioners) were very much regarded as family friends. The popularity of group practices, deputising services, appointment systems and other modern pieces of administration have done much to come between the doctor and his patients.
Question 14:
Do
you
think you could turn to your doctor for help, advice, support if you had personal
problems which weren’t necessarily health related?
a) yes 24%
b) no 76%
Comment
Once again this is a sad commentary on the state of modern medicine. Few people
(outside the Jewish faith) now turn to their local religious leader for help,
advice and support with personal problems. And our stressful and demanding lives
mean that more people than ever need someone in their community to whom they
can turn. Mental and spiritual health are largely ignored – even though
both have a significant impact on physical health.
Question 15:
Do you have difficulty in seeing the doctor of your choice?
a) yes 32%
b) no 68%
Comment
At first sight this result is quite cheering. Most patients have no difficulty
in seeing the doctor of their choice.
But the fact that
nearly a third of patients do have difficulty in seeing the doctor they would
prefer to see (usually, the doctor who knows something about them and their
health) is an indictment of the modern medical appointment system.
‘If I want to see my own doctor I have to ring up two weeks in advance,’ complained one reader. ‘I can get an appointment to see ‘a’ doctor within 24 hours. But the doctor I get to see is usually one of the young trainees who knows nothing about me or my medical history. I always feel much safer and far more reassured if I can see the doctor who knows me, but in an emergency – the one time when it really matters – I invariably have to see someone else and settle for second best.’
Click here for the results to the survey.
Note1: Age,
sex and nationality don’t seem to make much difference to the way people
feel about their relationship with their doctor. Young patients feel the same
as old ones. And women feel the same as men.
Copyright Vernon Coleman 2001