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    Health Care Reform:

    Health Insurance & Affordable Care Act

    Getting the Care You Need

    The Accountant Will See You Now continued...

    "I worked for 15 years studying my own patient-communication skills and learning how to teach them [to others] -- but after all that work I didn't see the [healthcare] world changing very much," Suchman says. "I began to see how healthcare organizations treat people: they create this force field of depersonalization. So if you are depersonalized, it is hard to treat your patient like a person. On the emotional and interpersonal level, the practice of healthcare [today] is primitive."

    The Well-Informed Patient

    Levinson, Suchman, and Neuwirth each talk about how the roles of doctors and their patients are changing. They all say one factor in this changing doctor-patient relationship is the rise of Internet health sites that provide patients with state-of-the-art health information.

    "Patients want to play an active role [in managing their health] -- they now say, 'You are not doing anything to my body without me understanding it and going along with it,'" Suchman says. "As patients are changing their role, the question is how that affects the role of [healthcare] professionals. The current model of medical professionalism sees a person who becomes a patient as helpless, dependent, and passive. Can physicians shift out of that role to lift patients up rather than hold them in a passive position?

    "Well, I find this new role more satisfying," says Suchman. "I get a partner instead of a person on my shoulders. But there has to be a change in expectations [on the part of the patient]. If the patient is going to think I am an idiot for not knowing something, I am not going to want him to look on the Internet. And I think we both lose in that case."

    Neuwirth says that the patient and the doctor each have to take responsibility for changing the nature of their relationship -- even if the current state of healthcare makes that difficult.

    "The system is fixed against improving the doctor-patient relationship, and people have to be creative to change that," he says. "I think patients have the ability to stand up and speak for themselves. They can say 'I want' a certain amount of the time: 'I want you to listen to me, I want to ask you a certain number of questions. We can visit more frequently, or do it by phone, but I really want this kind of interaction with you.' And there are people who do that."

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