There is pressure on doctors to ‘follow the evidence’ even though the evidence may be deeply flawed and biased due to considerable conflicts of interest. Another concern is the fact that doctors are remunerated for doing certain things, which can make it difficult for them to take a truly objective stance of some of what they do.
Patients who dissent and question or refuse treatment are openly scolded. There are many potential examples of this, but mammography and treatment with statins readily spring to mind.
The end result is that patients can end up being exposed to interventions for which there is little indication or evidence of benefit. Worse still, they can feel pushed or cajoled into things that they feel are not right for them…
…Particularly in the information age, individuals have much more access to medical information than they used to have. While doctors can be dismissive of ‘Dr Google’ I, for one, am not. The fact is patients often have more time and more motivation to research their health issues and arrive at plausible diagnoses. Whatever insecurities we doctors have about the fact that the patient may have made the right diagnosis (and not us) need to put to one side, I think.
In my experiences, patients are not infallible, but rarely do their ideas have no merit. Usually, they are highly useful. My personal view is that patients should be listened to when they offer their views on the cause of their symptoms. And even if they don’t, my experience tells me that perhaps the most useful questions a doctor can a patient is: “What do you think is going on?” (continue reading here)
It makes sense to remind doctors, here, too that they are not infallible either! I have often pointed out the fact that Dr. Briffa underscores above…patients have the time to research their particular health issues…doctors do not and rarely actually do any research at all for any particular one patient. If something a patient presents with is simply outside of the scope of a doctors experience it’s likely that patient will go with their needs unmet or worse yet their situation will be made worse. Iatrogenic illness is rampant in medicine.
It’s important to note that this sort of coercion in medicine by doctors who imagine they always know what is right for their patients is common to all of medicine, not just psychiatry where force is quite often openly supported by the establishment.
I have chosen to only work with MDs (as well as any sort of alternative practitioner) who are willing to be my full partner and acknowledge that I may very well know a whole lot about my body and mind. Having a good doctor who understands this means that together we can be detectives and make sense of those things I’ve noted about my body and symptoms. Two heads are far better than one and certainly an appropriate doctor can be indispensable. For many of us traumatized by the medical establishment it becomes very hard to trust again. It is possible to learn how to create these healthy partnerships, however. See: Medical compliance? Adherence? Screw that. My MDs are my PARTNERS
The time for doctors being the authorities on every aspect of our health care has passed. Good doctors understand this. Good doctors will be willing to be our partners in our health care.
I realize that good and safe medical care is not something everyone has access to. We must, as a society, work towards correcting this too.
Lastly for prescribing physicians who are, indeed, willing to listen, please see: A plea to prescribing physicians and psychiatrists: please help us heal (share that with all the MDs you know!)
I have spent thousands of hours regularly updating this blog over the last 5 years. If you have found my work helpful and can afford to do so, please consider making a contribution and becoming a supporting subscriber of Beyond Meds.