Doctor - Patient Relationship:
 A Vital Factor in COPD Treatment
                                                             By Brenda J. Hoilman RN

A lot has been said already about the importance of forming a good doctor/patient relationship.  You can't stress the importance of this relationship too much. It is vital, especially to those who have chronic diseases.

A doctor patient/relationship is a working relationship.  One thing you need to remember about the doctor and patient.......these are two people who should be working toward the same goal.  That goal is to help you, the patient,  be as well as you can be, and to help you be as comfortable as you can be. Working together, you and your doctor can form  a very strong partnership.

Szasz and Hollender (1956) described different doctor/patient models arising around different types of illnesses.  The passive patient and assertive physician are the most common reactions to acute illness;  less acute illness is characterized by physician guidance and patient cooperation;  and chronic illness is characterized by physicians participating in a treatment plan where patients have the bulk of the responsibility to help themselves.   Hey, guys, that's us!
Having a chronic illness, we must be active participants in our own care. That means knowing our medications, what they do, what side effects they have, how to do any prescribed treatments, how to have some control over symptoms, what things need to be reported to the doctor, how to check peak flows, making doctors appointments, calling to report changes, noticing changes in our own condition, keeping records.  It means following doctors instructions.  It mean taking the effort to learn.  It means educating yourself about your illness.
If you don't feel comfortable with your doctor for whatever reason, you need to find another doctor.  You will not have an effective treatment plan if you and the doctor are not able to work together.

What some patients complain of:   Doctor does not sympathize.....he/she does not seem to care that I am does not offer explanations or answer questions...... doctor does not have time, is too is abrupt.....has poor bedside manner......communications are poor.

What some doctors may complain of:   Patients do not follow treatment suggestions. ...patients refuse to participate in their own care and expect me to make a miracle cure... some patients continue to smoke and still expect us to cure them.!!!   Some patients have unrealistic expectations...some are full of anger......They refuse to accept that there are some things we cannot do. They get angry at us because we cannot cure them.

We, as patients, need to know that, in the doctor/patient relationship, as in any relationship, there are rights and responsibilities on both sides.

You have the right to expect pertinent information and explanations from your doctor.  The doctor has the right to get information from you on all important developments related to your illness.

You have the right to be allowed some input into your treatment plan.  What you want matters.  The doctor has the right to guide your treatment course. You need to have respect for your doctor's knowledge.  These two points are compatible.

Your doctor has the responsibility to keep up on the latest treatments and medications.
You have the responsibility to learn about your illness, medications, and treatments.

In review, you must work hard to form a really good doctor/patient relationship.  Ask questions.......thank your doctor........have consideration for his/her expertise.  Remember that doctors aren't God and they cannot fix everything.  With you and your doctor working in the same direction,  you have a very powerful team, and the one who will see the most benefit is YOU.

Brenda J. Hoilman RN
July 1998 (Revised)

On November 28,1998, shortly after this article was revised, Brenda passed away.  She will be missed.


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