What Happened to Medical Care?
“All mortals tend to turn into the thing that they are pretending to be.”
- C. S. LEWIS
The Ideal of Caring
Why do people want doctors like the venerable GPs? The answer is simple: The General Practitioners of the world became personally involved with patients as people. I don’t mean tending to diseases that happen to have patients attached; I mean caring for people.
Patients are not health statistics or dollars earned. Most especially, they are not an interesting case. Their needs go way past the prescription pad and the surgery table. Their needs are physical - but they also are complete human beings with emotional, psychological, social, economic, and spiritual needs. Doctors should be people-oriented servants of mercy whose mission is to relieve suffering of all kinds.
Some say doctors like this are extinct. Are there doctors like this in the world? You bet there are. Two uncles of mine were real-life General Practitioners. Dr. Donald R. Hinton and Dr. Robert L. Hinton knew patients by their first names. When patients had personal problems, they dealt with them directly. They were greeted by patients as members of the family at the hardware store, in church, or at the grocery. These were doctors to look up to, and in my practice, I try every day to follow their excellent examples.
Is the personal touch important? Medical experts know the personal touch can be the difference between life and death. Some newborn babies suffer from "failure to thrive:" They fail to grow and develop normally, becoming weak and sickly in spite of good nutrition and care. Some of these babies die. What causes this deadly problem? American orphanage research shows that failure to thrive results from a lack of physical cuddling and love. These babies actually die from a lack of personal love and affection.
Should all doctors hug their patients? Within reason, it never hurts - and it often helps. More important is a loving, caring attitude from the doctor to the patient. People know when their doctor cares about them - through a sympathetic hand on the shoulder and an open and caring attitude. It may be difficult to measure or prove, but we all know that patients need love and concern from their doctors to recover their health. That is why one of the most important ideals of medicine is caring.
Business versus Healing
The business side of medical care is in severe disarray. Everyone needs medical care, but a solution for how to pay for it eludes us. Patients are caught between the need for medical care and punishing medical costs. As the baby boomer segment of the population ages, the number of older people who need medical care has grown. The strain of finding ways to pay for medical care is causing a financial crisis and forces more and more emphasis on cutting medical costs.
There is nothing wrong with keeping the cost of medicine as low as possible. Cutting costs today, however, often seems more important than helping people recover their health. Insurance companies and government refuse to pay for services without rigid compliance to mountains of regulations and paperwork. The resulting conflict makes life miserable for doctors and patients alike.
Today's economic pressures threaten to make the caring doctor-patient relationship extinct. This is a tragedy because effective medical practice relies more on compassion, understanding - and, yes, love - than business concerns. When we only watch the bottom-line costs of medical care, we easily assume there is little to it other than the doctor poking around and writing prescriptions. Yes - patients need the technical knowledge and skills of the physician, but that is not all they need.
Medical care is no longer a private matter between caring people. What was once a sacred trust between doctor and patient has deteriorated into just another tough business deal. Today's medical mess results directly from doctors and patients alike turning their backs on the ideals of medicine.
Doctors are supposed to place the needs of the patient above all else. Patients are supposed to respect the doctors and take medical advice to heart. True healing requires a doctor-patient relationship based on mutual love, care, and concern. This healing relationship has more in common with family than with hard-nosed business practices. Today’s healthcare system delivers just the opposite.
What can we do about this? As in all other fields, practical applications come from theories. Medicine got into the present mess by holding to the wrong theory. We need a new theory – one that will return medicine to its ideals. But whether we like it or not, we are where we are. What drives the non-caring, bottom-line approach to medicine? How can we change it? Stay with me as we explore this subject further – and come up with some good answers.