|Year : 2017 | Volume
| Issue : 3 | Page : 135-138
Kindling Trust, Instilling Faith: Open Sesame to a Healthy Doctor–Patient Relationship
Yatish Agarwal1, Rashmikant Dave2
1 Editor-in-Chief, Astrocyte; and Professor of Radiology at New Delhi's Safdarjung Hospital and Vardhman Mahavir Medical College, India
2 Honorary Executive Director, National Board of Examinations; and Executive Editor, Astrocyte
|Date of Web Publication||30-Jan-2018|
Honorary Executive Director, National Board of Examinations; and Executive Editor, Astrocyte
Editor-in-Chief, Astrocyte; and Professor of Radiology at New Delhi's Safdarjung Hospital and Vardhman Mahavir Medical College
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Agarwal Y, Dave R. Kindling Trust, Instilling Faith: Open Sesame to a Healthy Doctor–Patient Relationship. Astrocyte 2017;4:135-8
Close to two hundred and fifty years ago, the great French philosopher and writer — a man whose works epitomize the Age of Enlightenment — François Marie Arouet de Voltaire, while penning his thoughts about physicians set them on the following high pedestal  –
“Men who are occupied in the restoration of health to other
men, by the joint exertion of skill and humanity, are above
all the great of the earth. They even partake of divinity,
since to preserve and renew is almost as
noble as to create.”
Down the ages, these serene thoughts guided by the soulful sentiments of unbound faith, trust, confidence and respect were the core defining characteristics of a doctor-patient relationship that gave the bond a terra firma, and imparted it a pious force, importance and substance. In those early years, patients and their families revered physicians as exalted holy souls, and considered them to be imbued with superhuman healing powers.
The truth is, most people, who throng the doors of a medical establishment, still largely wear the same state of mind. They still think of physicians as demigods; and devoutly wish within their hearts that we will stand up to their expectations.
That's why if a physician, nurse, paramedic, or medical institution wishes to measure their success, they must recognize that preserving, enhancing, and justifying confidence, trust, and faith among the people must remain a fundamental goal and guiding mission for them.
Of eroding binding values
If these vital binding values get eroded, the doctor-patient relationship takes a tumble — trust is overwhelmed by distrust; rationality is swept aside by unreasonableness; courtesy succumbs to disrespect; and people's vulnerability, frustration, and the hypnagogic perception of having been wronged, boils into an uncontainable resentment and rage. Most of the irate public outbursts, ugly wordy duels, and sometimes, fisticuffs and physical violence, owe their genesis to these psychological pathways.
Such ugly instances, deplorable as they are, have become increasingly common. They reflect the changing values and intolerance of the social fabric — be it the political class, judiciary, executive, media, or the common man, which breeds a severely suffocating ecosystem for physicians, who're increasingly feeling strangulated.
Mechanisms at play
Much of such intolerance exhibited by people may be misplaced, but it is ground enough for us to introspect deeply. We must search within ourselves where we are falling short of the expectations of people, what is being perceived by people as off beam, and where we are actually going wrong.
The truth is, most people, who throng the doors of a medical establishment, still think of physicians as demigods; and devoutly wish within their hearts that we will stand up to their expectations. Upholding and justifying this sacred confidence, trust, and faith among the people must remain our fundamental goal and guiding mission.
Social scientists and psychologists would have us think that when people — be it a patient or their caregivers, mostly the latter — resort to violence, it is an expression of their dissatisfaction with the doctor and medical establishment that they believe has failed or cheated them. However, if we dig a little deeper, we may find the roots of such behavior may be planted in the vulnerability they may naturally harbor in those times of deep anxiety, stress and trauma.
Should their expectations be met, these very psychological processes compel them to sanctify their trust in the physician raising him to the pedestal of a demigod. However, should a doctor or medical establishment fail them, this very sentiment even if totally unreasonable, turns into a reaction filled with deep mistrust, disrespect, anger, and violence.
The right course
While it is true that patients and their families many times expect too much of a doctor or medical establishment, fail to recognize the frailty of human life, or the selfless spirit with which most physicians work, and err horribly in erupting in violence, it is quintessential for us, the physician community, not to become reactive.
Whatever be the odds, the old sacred virtues of goodness, kindness, and integrity must be kept alive if the profession has to retain its halo of nobility and divinity. We must nurture a compassionate and caring heart, a devoted and dutiful attitude, and build on our skills, knowledge and wisdom. While this must be our anthem, we cannot afford to slack on many other scores.
Developing good communication skills, being patient, and taking out time to address the concerns of patients and their families must become a core component of physician's skills. Know that people often cannot distinguish how highly proficient or skilful a doctor may be, but are likely to distrust him should he practice unfriendly aloofness or if he is impatient and dismissive.
Howsoever grim the clinical state of affairs be, giving a patient ear, being a good listener, and offering an honest appraisal of the ground situation can pull us through most difficult times. On the other hand, should we appear apathetic, discourteous, brazen, or unconcerned, we are sure to set the pot boiling! If such behavior on our part sours, scalds or scars the doctor-patient relationship, we have only ourselves to blame. While our godly image must suffer individually, collectively it tarnishes the reputation of the medical profession.
Should people's expectations be met, the age old psychological processes compel them to sanctify their trust in the physician raising him to the pedestal of a demigod. However, should a doctor or medical establishment fail them, this very sentiment turns into a reaction filled with deep mistrust, anger, and violence.
Nearly a hundred and eight years ago, Sir William Osler, a celebrated Canadian physician and teacher had said  –
“We are here to add what we can to life, not to get what we
can from it. Nothing in life is more wonderful than faith – the
one great moving force which we can neither weigh in the balance
nor test in the crucible. Intangible as the ether, ineluctable as
gravitation, the radium of the moral and mental spheres,
mysterious, indefinable, known only by its effects, faith
pours out an unfailing stream of energy while abating
nor jot nor tittle of its potency.”
Let this be our guiding light, as we buckle down to give our best to this most haloed wonderfully humane profession, which carries a heritage few can equal.
| References|| |
Osler W. The Faith That Heals. British Medical Journal, 18 June 1910: 1470.
Gupta DK, Sethi RS. Personal communications. 2017.