The future of medicine doesn’t include the doctor patient relationship
Really?
I’ve always believed the bedrock of medicine is the relationship between a patient and their physician. It is the essence of medicine, to help another.
Yet, I was shocked when I saw the words of advice to medical students by Dr Sachin Jain:
“The simple image of the physician-patient relationship that draws many of us to medicine—the dedicated physician, the thankful patient—is no longer.
It has been replaced instead by one in which the patient is at the center—and the physician is part of a broader team managing the health not just of one patient at a time, but of whole populations.”
Yes, healthcare is changing because of the system’s failure. But to discard the very root of medicine appears unwise, if not foolish.
Today medicine focuses on population health not individual health. It worries me because this focus on populations and “the greater good” historically comes at the expense of individuals. (Remember Stalin’s take: One death is a tragedy, a million deaths is a statistic)
Medicine takes place at the individual level.
The humanity of medicine is in the doctor patient relationship. The caring, sharing, and interventions happen one patient at a time. If you take that out of our healthcare system, you end up with an expensive, bureaucratic biological repair shop.
Will the doctors and nurses in the hospital act like the employees of your local DMV?
Do they already? Hopefully not.
Now you may disregard what I say because I am not a physician like Dr. Jain. But there are numerous physicians that believe the doctor patient relationship is vital to medicine.
Dr. Venu Julapalli [at video location 2:34] says it perfectly:
“[Medicine] It’s all become population based. And all that’s important. But really when it gets down to it, what is that person needing right there in that moment. What’s the unique situation? And how can I meet that in that moment, right there and then. That’s the healing relationship. Two unique human beings that can’t be distilled down into some cook book medicine.”
I pray that Dr. Jain is wrong about the future of the patient doctor relationship.
The last hope for this important relationship is the DPC movement. It’s stunning that the innovation of DPC is the direct relationship between a patient and their physician. With all the advances in technology, it should be easier than ever for patients and physicians to communicate. But it’s not.
Medicine should be broken up.
It’s big business. Keep the expensive stuff in the hospitals and ASCs. This is where you need insurance (and how it was originally designed). And outside of insurance networks and payments, let patients find a DPC physician that they can have a real, personal relationship with.
Personalized medicine is already here. Give patients and physicians time to develop a real relationship.
Hopefully Dr. Jain and other planners can listen to Dr. Julapalli and other clinicians, to see the benefit of keeping that relic of medicine, the physician-patient relationship, intact while they plot the future of healthcare in this country.