Where Did the Doctor Go?

I see a lot of doctors. I know that every time I come home for an extended vacation there will be many specialists to see and more tests to be done. When I’m lucky, I get the prescriptions faxed to me at school and complete the tests there. The end result is that I’ve gotten pretty friendly with my doctors: they’ve written recommendation letters for me, connected me with colleagues so that I can better observe the profession, and have been more than available to me for any questions I might have about my own health. And most importantly, all of my various doctors are know able to allay my mother’s fears and put her at ease when the need be—hardly an easy task.  

The Doctor by Luke Fildes

Yet, I know I’m the modern anomaly. Most of my friends and peers are not nearly as friendly with their doctors—someone they usually see once a year for an annual checkup and to fill out some forms for school. My brand of doctor-patient relationship is more typical of 19^th century England (though slightly more technologically advanced). Physicians of that time were locally based and could get to know an entire family over successive generations. I was particularly surprised to learn that patients often only died in the company of their doctor, who was charged with sitting the bedside vigil often with no loved ones present.

So how did we get from the 19^th century revered family doctor figure to the 21^st century doctor who practices his craft in constant fear of a lawsuit? In America, between 15,000 and 19,000 cases of medical malpractice are filed each year, with the cost totaling upwards of 50 billion dollars (most of that in unnecessary tests). People today are significantly less inclined to trust their doctor, and I simply cannot imagine why. Doctors go through some of the most rigorous training of any profession: four years of graduate education, residencies, fellowships, medical Boards Examinations, and so much more. They even swear an oath, promising to “Enter only for the good of my patients, keeping myself far from all intentional ill-doing.” So why have we become increasingly more critical of doctors in the 21^st century?

The post-Enlightenment era is marked by greater faith in the faculties of the human mind, which evolved into an intellectual independence free from religious stricture. Especially among Deists, there evolved the idea that God is a faraway entity who is no longer active in our world. This empowered the citizenry to think independently, to devise worldly solutions to those everyday problems of sanitation and disease, but also the broader questions like the age of the planet we live on. In the 21^st century, this type of intellectual independence, the freedom to answer those questions you choose to ponder without fear of spiritual fallout has pervaded the entire culture. Knowledge is no longer off limits to anyone.

While the dissemination of medical information has done wonders for healthy living, I think the widespread education has backfired in some ways. With drugs advertised on television, WedMD’s symptom checker as a diagnostic tool, and countless remedies over-the-counter, people can be their own doctors. Armed with this small amount of information, people feel more comfortable making potentially dangerous personal healthcare decisions. I’m not advocating putting absolute faith in the medical professionals because being informed never hurts; but, being informed in the proper way, by people whom you trust and who are qualified and are open to communication, is most certainly the best way to go. Still, when there isn’t open and effective communication with healthcare providers, or a comfortable relationship with one’s doctors things can go wrong. As a species, we tend to blame other people, and when it comes to healthcare it’s usually the doctors who have to deal with it—in court.

There's always one lawyer who will take my call

I hope to become a doctor and have a more familiar relationship with my patients like the local family doctor of 19^th century England. Patients are not simply waking ailments but people with family members and real concerns that need addressing. I hope to provide an emotional comfort to my patients and their families beyond the prescriptions and medical expertise. In the end though, I’m still grateful that my brother is a lawyer and will (hopefully) always have room for one more client.

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