Word: physicians
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Dates: during 1980-1989
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...Once most people treated me as a friend and a confidant," recalls Boyd McCracken Sr., 65, a family practitioner from Greenville, Ill. (pop. 5,000), who remembers making late-night house calls. "These days the malpractice threat has created a definite wedge between a physician and some of his patients...
There are rich ironies here. Never have doctors been able to do so much for their patients, and rarely have patients seemed so ungrateful. Eighty years ago, a sick man who consulted his physician had roughly a fifty-fifty chance of benefiting from the encounter. The doctor's cheery manner and solicitous style were compensation for the uncertainty of a cure. "Medicine originally was mainly talk," says Sidney Wolfe, a physician who directs the Public Citizen Health Research Group in Washington, "and very little effective diagnosis and treatment...
...from someone who must spend roughly twelve years learning the trade, work impossible hours, be available to patients day and night, keep abreast of changing technology and live a peaceable life while constantly dealing with death. "The patient wants the best of both worlds," charges Lester King, a Chicago physician and medical historian. "He wants the knowledge and precision of the most advanced science, and the care and concern of the old-fashioned practitioner...
Other patients are shopping not for savings but for status. This inspires physicians to spend valuable time on self-promotion and merchandising, not skills that contribute materially to patient care. "My feeling was that if you're a decent physician giving decent service, that's really all you should have to do," says Florida ophthalmologist Robert Rogers, who has hired a business consultant to help manage his practice. "But patients don't seem to want that. They like the flashy stuff. They like to see your name in print. They like to see you lecturing...
...today's patients read books with titles like What Your Doctor Didn't Learn in Medical School and Take This Book to the Hospital with You. The message is that a smart patient is an informed patient, who challenges a doctor's authority rather than submits uncritically to the physician's will and whims. Yet that approach rubs raw against a basic instinct. Patients want to trust their doctors, to view them as benign and authoritative. Even those who privately question a doctor's decisions may be loath to express dissent. Doctors admit that an aggressive or challenging patient...