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Wednesday, April 2, 2014

Patient-doctor relationship should always come first

By Thomas Estep
Special to the Eagle

Pundits and critics alike cite numerous “fixes” designed to heal our broken health care system. But any change to our health care system should start with the patient and the physician. Both have fundamental roles and responsibilities that, when adhered to, make the health care we deliver and receive in our region very effective. Let me explain:

When the door to the examination room closes, the interaction between the physician and patient takes on a special meaning. Trust, honesty and a singular purpose to heal and comfort become the essential elements of that interaction. As a physician, I am committed to this sacred patient-doctor relationship. I believe that one way to maximize our health care system is to prevent any barriers interrupting this relationship.

No institution, insurance company, hospital or government agency, nor the goal of personal gain, should ever inject itself between the patient and physician. However, in today’s health care environment, too often physicians must contend with numerous attempts to intervene between the patient and doctor.

The Hippocratic oath, graduate medical training and accumulated clinical knowledge and experience shape physicians’ ability to deliver quality care to patients. Doctors also must rely on “best practice” parameters and proven evidence-based medicine to provide the best possible care to their patients. A bond of trust that physicians will humanely treat patients as if they were members of their own family or they were the patients themselves enhances this kind of care. Outside forces that interfere with this relationship can only detract from the quality and compassion of care rendered by the physician.

The patient also has a responsibility in this relationship, specifically to pursue a healthy lifestyle in accordance with the doctor’s recommendations. Too much of a physician’s efforts to heal or impede disease occurs during a time of crisis when prevention is no longer an option. Healthier actions pursued by patients can often prevent the progression of a disease to chronic debility or other severe consequences.

Giving patients an incentive to maintain a healthy lifestyle is pivotal to decreasing the enormous costs of long-term health care that arise after chronic diseases become established. For example, smokers who cease using tobacco save the health care system billions of dollars for conditions such as pneumonia, emphysema, cancers and vascular diseases.

I do not think our health care system can continue to fund the ever-expanding needs of chronic diseases that occur from unchecked and unhealthy behaviors by a growing U.S. population. Patients must be engaged in making our health care system work and fiscally solvent, not just for themselves, but also for everyone.

Physicians and patients together should lead the way in making the most of our health care system. When physicians take leadership roles, good things happen for their patients. When patients take responsibility for their health and health care, our system is at its best.

I believe reform should start by protecting the sacred patient-doctor relationship, with each taking full responsibility for their respective roles. By doing so, we have a greater chance that we will pass on a caring, effective and fiscally intact health system that will deliver quality medical care to future generations. We all have a responsibility — patients and physicians alike — to make the system work, and I, for one, believe together we can make major progress.

Thomas Estep, a cardiovascular and thoracic surgeon in Wichita, is president of the Medical Society of Sedgwick County. He practices with Wichita Surgical Specialists PA.

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