Tincture of Time

Written by Clif Steinberg, ND for the Brattleboro Reformer June 13 2014

The press and other media are overflowing with stories about the myriad problems with our modern healthcare system. It has become a very big and polarizing political issue, as well as a huge economic issue, with a couple of decades worth of skyrocketing costs that consume an increasing slice of our economy.

Healthcare is also a significant moral issue, with questions about care accessibility and quality. The whole thing is truly a mess, and the solutions are elusive at best, leaving many of us with a sense of despair.

Lost within this loud din about our enormous healthcare system is an issue on a more human scale that might hold a key to a better kind of care. I am referring to the suffering of the doctor-patient relationship, and especially how that is reflected in high patient loads for doctors and short office visits for patients. Those factors have depersonalized medicine to a large degree, and have led to less satisfaction on the part of patients. This state of medicine has also impacted physicians in big ways, leading many to question their career choices, and even causing some to leave the profession altogether.

There are a lot of reasons things have gotten worse for primary care doctors, and most of them are complex and defy easy answers. But if we hope to have high quality care, then we absolutely need to have high quality healthcare practitioners with enough time and energy to feel good about their work. If, on the other hand, we have people delivering the care who are rushed and overwhelmed, then we can expect the care itself will suffer, which appears to be the trend in recent years.

The point here is that the doctor-patient relationship is tremendously important in healthcare. I believe that a lot of the art of medicine is based on the dynamics of that relationship, and on the mutual trust that emerges. In the modern version of primary care medicine we have seen the doctor-patient relationship deteriorate to a point where there is often very little trust developed.

Primary care practitioners are frequently burdened and rushed by forces largely outside of their control. As a result, they often are not allowed enough time with their patients to foster good patient relationships. This is unfortunate, and both the patient and the doctor are the poorer for it. Nowadays, instead of relying on time and trust as the best medicine, doctors are forced to use prescription medications as their main tools.

As healthcare consumers we can still influence the system simply by directing our own healthcare spending towards practices we appreciate. There are practitioners who prioritize time with their patients, personalizing it as much as possible--in spite of the obstacles in their way. I think it is well worth the effort to seek out ways to support those kinds of practices. In the context of a healthcare system so out of balance it is not always a simple matter to do that.

If you do find a provider who seems content in their work, and who will spend a few minutes extra with you to get the bigger picture of your life, then you will likely be receiving better care, not to mention helping to move healthcare in a good direction.

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