What Is A Doctor’s Role

schs-topic-2-doctors-professional-duties-4-638The one question never asked of me through my education and years of clinical practice was, “What is a doctor’s role?” To some it means healer; to others it means unlimited potential for material wealth and possessions. I believe answering this one simple question can help patients defines the PERSON and and determine if their role as doctor fulfills their needs.
I can tell you that my answer encompassed wearing many different hats at any given time. This answer may sound nebulous, but the skills required of a doctor entail so much more than understanding pain and disease and dispensing treatment. As a doctor seeking the root cause of presenting problems, it was essential for me to obtain a patient’s personal and health history. These intake forms provided great value. Colleagues commonly skimmed through this information eager to get to the symptom questionnaire. So much valuable information could be found on a patient’s history intake form. It provided insight into a patient’s perception of health; it provided information determining the type of healing that would most effectively address the problem; it provided obstacles that could interfere with a speedy recovery; it assisted in determining whether the problem was more likely physical or mental and it told me what the odds were that I could help this person. That, in my opinion, is a lot of information. This is why I sat down with new patients and discussed these details. Sitting down and taking the time to understand their situation added value and credibility to the office visit.
I believed it was also my job to help the patient understand their role in addressing the presenting problem as well as their role in maximizing their health. Early in practice, I believe I misunderstood this role by attempting to educate everyone about what steps were needed to live the healthiest life possible. I was wrong with good intentions. I learned in time that it was my role to help my patients achieve the quality of life THEY chose and worked within these parameters to maximize these results. This was very difficult, because I knew people could have better outcomes. I always left the door open if they decided they were ready to pursue better outcomes.
Skillful communication was also a role I needed to develop. Confidence and trust are two important words that need to be earned as a doctor. Many doctors believe that this is a given because of all their hard work in becoming licensed physicians. They’re wrong! A patient that doesn’t believe in their doctor will often not comply with their treatment recommendations. Sometimes compliance (or partial compliance) by the patient occurs because they recognize how important they are in their doctor’s eyes and want results to make their doctors feel better. Imagine, a patient caring more about their doctor than themselves. This shows an interesting dynamic in the patient-doctor relationship. When a patient knows that their doctor truly cares, outcomes are significantly improved. For this relationship to develop, a doctor has to be willing to LISTEN to their patient. The art of listening becomes another vital skill a good doctor develops.
Another important role for the doctor is the recognition of limitations. When a doctor sees a lack of progress in their patient, he or she must decide if it is time for another set of eyes to evaluate this patient. This means a doctor must be willing to place their ego of the side and accept possible failure for the benefit of the patient. A good doctor with good communication skills will explain the need for referral and will gain additional credibility and respect from the patient knowing this decision was made in their best interest. This creates a stronger bond and increased confidence in the healthcare provider.
As you can see, examinations and treatments only play a part in the doctor’s role. Unfortunately, this is the only part that health insurance companies recognize. It is difficult to be a good doctor because the system places many limitations on the doctor’s ability to do their job well. Job performance can be based on patient volume, patient prescriptions, average cost per office visit, etc… The healthcare industry has become such big business, the patient has been reduced to a diagnosis code and treatment code. To turn this scenario back into the relationship that once existed, I encourage all readers to ask the one simple question to their doctor; “What is a doctor’s role?” The answer will help you decide if the doctor standing (or sitting) in front of you is ultimately going to be your best ally.
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24 comments

  1. I knew *something* was up with me for awhile but several doctors told me that I was fine. I felt very dismissed but I didn’t stop being my own advocate and searching for someone who would give me answers. It was only when I met my new GP that I was finally diagnosed. I am still going through the process and meeting with other specialists, but I have a lot of trust for my family doctor because he took the time to listen to my concerns (and not just see what was physically manifesting itself – or wasn’t) and actually did tests to follow-up.

    I agree that communication is also crucial. My last GP wouldn’t even remember major health issues that happened in my life because he was cramming five patients into a 15 minute time slot and had no time to review notes (and was too busy to remember basic details…what level of care could he possibly provide?). We didn’t have a good rapport after years as doctor-patient.

    Now I have developed what I’ve always been seeking in a doctor with my new one. In fact, every time I see him, I am hoping that he notices I’ve lost more weight. I know he cares and we are both invested in seeing me succeed and be the healthiest that I can. He took the time to understand my history in depth, my parents’ history, and also to understand my goals and fears about my own health. I live in Canada where health care is “free” (as in paid for through high taxes) but the standard of care is really lacking, the wait times are incredible, and the system is very flawed.

    I don’t feel that people are being set up for success, health, or longevity. I feel lucky to have found my doctor and I hope he never retires!

    Liked by 1 person

    1. At 28 years of age, you are way ahead of most people your age. Your drive and self awareness has been a great asset. You live in your own body and know it better than anyone else. As a doctor, we try to ask the questions to get our patients to give us the accurate answers. This is where the working diagnosis comes from. The lab tests we perform as well as the diagnostic imaging are just tools used to confirm the findings. In today’s world, I believe that many doctors handle this backward. They order the tests first hoping to find conditions that are then treated via an algorithm. That all so important dialogue (communication) is bypassed to increase the number of patient visits seen in a day. I believe this to be a huge mistake.
      Your GP sounds like a terrific doctor. The good news is, if he or she ever retires, their concern for your well being will be demonstrated by their assisting you with finding a new quality physician able to step in and comfortably take over. As I’ve said to you before, you are on a great path that many should follow. Best of continued success.

      Liked by 1 person

  2. “Skillful communication was also a role I needed to develop.”

    “I was wrong with good intentions. I learned in time that it was my role to help my patients achieve the quality of life THEY chose and worked within these parameters to maximize these results.”

    “Another important role for the doctor is the recognition of limitations. When a doctor sees a lack of progress in their patient, he or she must decide if it is time for another set of eyes to evaluate this patient.”

    I appreciate all the points you’ve addressed and want to highlight the three above. They really stood out for me, because they demonstrate how you seem to strive to not only give advice to your patients but to also understand and listen to them. My grandmother used to say that there’s a reason why God gave us two ears and one mouth. Excellent article. My husband’s doctor would benefit from your words…..I may convince Jeff to find a better one, yet!

    Liked by 3 people

    1. When it comes to health, I don’t believe in settling. As the patient, we are the employers. We have rights and expectations. If our doctors are not satisfying these requirements, there are plenty of others willing to fill the void. I believe the best time to interview a potential new doctor is prior to the onset of an acute condition. Everyone involved can approach the interview in a more relaxed state. I hope your husband considers this option.

      Liked by 1 person

  3. I wish my PCP wouldn’t treat everything as a bad joke. He is dead set against believing in Fibromyalgia and so I have to watch what I say or he laughs at me. I wish I could stand looking for a new dr, but I don’t feel like starting over and then find out they are worse. The worse dr there isn’t there anymore at least.

    Liked by 1 person

    1. It does require effort and you may need to interview more than one doctor, but it all comes down to the quality of care you want from your doctor. There is no right or wrong answer. It is a very personal decision.

      Liked by 1 person

      1. My friend who also left there like I did, couldn’t find another dr. It took her a couple of years. Maybe she is just pickier. I don’t know. I just can’t stand the paperwork, getting to know them and then feel stuck with them. I don’t quit things easily. I had jobs I hated until they laid me off or in the case of my last one I went out on disability and never came back.

        Liked by 1 person

  4. Great Post. I feel so many people still treat Doctors as ‘God’s’ instead of listening or knowing their own body. Hence why so many people go undiagnosed or are sent for tests that are not needed. I notice this more in my parent’s generation and continue to encourage them to seek different opinions or perhaps tell the Doctor what they feel instead of the other way round.

    Possibly the reason for this, is because it is easier to allow someone else to direct our life, because for this to change, it requires a big effort to listen and know our body and to understand what is right for us.

    Liked by 1 person

    1. I understand your sentiments. The interesting thing is it is NOT easier to allow someone else to direct your life; it is only perceived easier. It is my belief that no one will ever know the body better than oneself. Finding a doctor that is willing to truly LISTEN (especially for the elderly) can be difficult. The best outcome is usually achieved with mutual effort from the patient and the doctor. It seems the healthcare industry has followed the restaurant industry’s lead. “Turning tables” (aka “turning patients”) creating high volume is the key to success. Call me naive, but I thought patient outcome was the key to success.
      Thank you for another great comment with great insight.

      Liked by 2 people

  5. I once had a friend who had a heart attack in her mid-fifties, followed by bypass surgery. Aftercare was difficulty, as her cardiologist asked her to make many lifestyle changes and she resisted. Finally, he told her that if she did not quit smoking, he would prefer she not make another appointment with him–he could do no more to help her. I wished at that time that he had referred her to a doctor who could have helped her with the smoking problem, but maybe he knew that was a work in futility. She never saw him again. She was dead of congestive heart failure at 56! What a shame her choice didn’t support a greater desire to live and be well. I think she trusted few people in her life and that lack of trust literally killed her.

    Liked by 1 person

    1. It’s a tragic story, but one I have learned to accept since the individual in this case made a conscious decision to live and and ultimately die by their own rules. Doctors don’t have powers to make people healthy. They can only help people who want to help themselves. I am sorry for the loss of your friend.

      Liked by 1 person

  6. Another great post and its U.S. very true. I went through a few specialists before settling on the ine I have had for several years. What is more important than your health. Seems you must have a real following of patients.

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    1. I loved my practice right up to retiring last September. I believe my patients new I was committed to helping them every way I knew how. They also knew I expected them to care about themselves as much or more than I cared about them. I was willing to help anyone willing to put the effort in to helping themselves. Those who came and told me it was my job to “make them healthy,” were either never accepted as patients or released early from care and referred to other healthcare providers as to not waste their time or mine. My attitude was tough (but reasonable), and I always smiled and maintained a gentle demeanor as I discussed their care.

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      1. More people need to take your advise and take ownership of their lives. I have had Crohn’s since my 20’s but never let it rule my life. I always felt when it limited me it won.

        Liked by 1 person

  7. “I believed it was also my job to help the patient understand their role in addressing the presenting problem as well as their role in maximizing their health. Early in practice, I believe I misunderstood this role by attempting to educate everyone about what steps were needed to live the healthiest life possible. I was wrong with good intentions. I learned in time that it was my role to help my patients achieve the quality of life THEY chose and worked within these parameters to maximize these results. This was very difficult, because I knew people could have better outcomes. I always left the door open if they decided they were ready to pursue better outcomes.”

    This paragraph is IT on so many levels! This “spoke to me” about more than just a doctors role but also in other areas of life! The sentence “I was wrong with good intentions” stole the show for me. Thanks for that! Regarding a doctor’s role, I definitely choose to be my own front line regarding mine and my family’s healthcare. Light and Love, Shona

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    1. Glad you liked the article. I’m even happier to read that you are your “own front line” regarding your health and your family’s health. A family advocate usually makes the best choices with the best results. Some doctors viewed questions during an office visit as a challenge to their credentials. I used to smile if patients asked questions because I knew this person was vested in their own outcome. It is so much easier to help people help themselves than to compete with them. You were my kind of patient. Stay strong and positive. Live life joyously.

      Liked by 1 person

  8. Excellent post! Not only beneficial for doctor’s but also for going-to-be-soon one’s like me 🙂
    I nominated you for the Encouraging Thunder Award!
    You deliver such an important message here, it needs to be heard my more people.
    Have a nice day!

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    1. Thank you for the tremendous honor. I am sorry, but I had to make a special trip. My mother is in hospice and I will be spending my time with her for whatever time remains. I did not want you to think I was ignoring your much appreciated nomination.

      Liked by 1 person

      1. I completely understand, as I recently lost my aunt to cancer. I wish you and your mother all the best, stay strong … .

        Liked by 1 person

      2. I am sorry to hear about your mother and hospice. I know what that means. My mother was in hospice with a DNR. She never regained consciousness, but we (my sister, dad and I) were all there when she finally let go. I am praying for you and your mother and your family that the time that remains goes as easy as possible. May God Bless you all.

        Liked by 1 person

      3. Saddened by the news about your mother, I want to say something helpful but cannot think of anything that goes beyond the usual trite bit of information: yes, I care.

        Liked by 1 person

  9. Thank you for your kind heart and thoughts. I have had to give up my time on publishing and reading articles and don’t want people to feel ignored. I know how much work everyone puts in and I respect their efforts. I hope to be back in about a week.

    Liked by 2 people

  10. I love how you framed this, “…it was my role to help my patients achieve the quality of life THEY chose and worked within these parameters to maximize these results.” This is such a critical factor for any healthcare provider and I think many miss it. You have meet your patients right where they are at and get them to accept incremental change which I bet is SO frustrating when you know so many other things they could be doing but won’t. Baby steps though I guess is key.

    Sorry to hear about your mum. It’s nice you can be with her though, I’m sure she appreciates that.

    Liked by 1 person

  11. Thank you Tricia. My mother has passed, but I’m certain that it was better that my family was able to travel to be with her prior to her passing. I hope to be back on line with the blogging community by Oct.2nd. I will miss all of you in the interim.

    Liked by 1 person

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