“Doctors prescribe pills. That’s what we do.” That was an actual quote from a trainee doctor last week.
It’s not a bad day to reflect one of the broken aspects of healthcare (both here and abroad): the doctor-patient relationship. Did you know today is National Doctor’s Day in US? Like many Irish docs, I had messages and silly memes shared from US colleagues today.**
A popular GP tweeted this week: “Should GPs be reimbursed for extra post-natal visits with new mothers to help support them?”
My answer? Yes, yes, so much yes. Her view was that the relationship between families and GPs was becoming too medicalised. I agree.
Because it should be more than: “Doctors prescribe pills. That’s what we do.” And yes, my heart broke a little last week when the trainee said that to me last week. She basically was annoyed and surprised that I was ranting when I received a memo that a hospital had suspended access to allied health professionals/rehabilitation for a group of chronic disease patients due to short staffing. Integrated and dedicated clinical psychology, dietitian, physiotherapy support for this patient group – on hold for foreseeable future.
I had been frustrated but then she just added to my despair:
How broken is healthcare if she sees her role in the doctor-patient relationship as just a pill prescriber? That she doesn’t understand that her fundamental role in the doctor-patient relationship is more than a prescriber – from disease prevention to halting disease progression to rehabilitation after treatment to shared decision making.
The doctor shortage in primary care and the long waiting lists for hospital medicine mean that those cornerstones of being a physician – health promotion, prevention, liaising with allied health professionals, assisting decision making, counselling, and lifestyle coaching – are being side-lined by shorter and shorter visits and longer and longer waiting lists. While prescribing medication and performing procedures are an essential part of the practice of medicine, reducing the role of the doctor to prescribing pills or performing a procedure misses so much. It also leads to unnecessary medicalization.
Poorer doctor-patient relationships also means poorer health and poorer outcomes for patients:
Pre-diabetes does not need to progress to diabetes.
High blood pressure does not need to progress to heart disease.
A quick reassuring “Is this normal?” visit at 3pm on a Friday can prevent an A&E visit at 3am on a Saturday.
And as for my young colleague? Part of my job is to teach her what I didn’t really learn until I was almost 10 years into the job and I found the right mentor: Evidence shows that good doctor-patient relationships aren’t just good for her patients but also good for her. She’ll be a better doctor and mentally healthier as a doc invested with her patients on their health journeys rather than just prescribing pills.
What am I doing this Doctor’s Day? I’m celebrating it by finalising the paperwork to bring Emdoc Health as a face-to-face in-person Clinic starting next month. I’m so excited. I can’t wait.
**Many countries, including Brazil, Canada, and Iran have a National Doctor’s Day. It will not surprise you that Ireland does not. Countries who celebrate pick their own dates; US picked the date of the first surgery under general anaesthetic and made it a National Physicians Week. It was actually signed into law there more than 30 years ago.
#lifestylemedicine #doctorpatient #NationalDoctorsDay #NationalPhysiciansWeek
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