Casualties of the Pandemic: The Doctor-Patient Relationship

The Doctor-Patient Relationship, once the foundation of the healing arts, took some real hits during our response to the recent pandemic.

Granted, allopathic medicine (also known as western medicine), has been undergoing significant changes in the delivery of healthcare over the years. Many of these changes concerned the shift in priorities from interactions with trained professionals to purchasing narrowly defined services and products. Turning healthcare into commodity-based interactions, for good or ill, has changed the very nature of the industry.

The pandemic just provided the opportunity for a dramatic leap in this evolution.

Takeover of the Doctor-Patient Relationship

Corporate Healthcare is probably better understood as an oxymoron than as an interactive exchange that is supportive of patients and the human professionals who provide professional services. (Pretty much gone are the days of the friendly general practitioner providing needed health services and advice, and the occasional lollipop as needed, to families.)

The giveaway of the new order is in the name: corporate. Money is now the working concern when assisting people with care designed to address their physical and mental ailments.

To put things in context, corporations are first and foremost businesses. They are built and operated as activities that make profits from their operations. Period.

My hat is off to them. Applying this model to what was previously a mixture of caring interpersonal communications and technological tools, has been a challenge. As consumers of the earlier versions of healthcare, we have managed to demand the retention of many of those warmer and fuzzier aspects of healthcare that made it a base of human interactions.

That has now changed.

Primum non nocere

“First, do no harm.”

Once thought to be part of the Hippocratic Oath sworn by physicians, this idea is still embedded in the training of healthcare professionals, but times are changing. The concept may still be spoken but the daily application of healthcare upon patients has evolved to reflect the sensibilities of the businesses that own the facilities and employ the professionals.

As the thinking goes these days, you don’t want to let a good disaster (or pandemic) go to waste.

A hallmark of behaviors during and after the pandemic has been the takeover of existing entities (whether they are businesses, political or social groups) and rework them into new forms. Absolutely subversive in nature and parasitic in action, these bastardized versions of modern institutions have and are changing our lives.

MIA: Informed Consent During the Pandemic

In the revision of healthcare that accelerated during the pandemic, one of the biggest casualties has been the adulteration, or often elimination, of informed consent.

Informed consent, while not always a recognizable activity, was a foundational component of the Doctor-Patient Relationship. Simply stated, informed consent is a conversation between doctor and patient about the patient’s healthcare and any procedures being proposed.

Simple interpersonal communication allows the patient to make decisions based on their understanding of proposed care.

Then came vaccine deployment. There was all the accompanying noise about loyalties, and something called “science” that had nothing to do with science. And do not forget the ensuing social free-for-all. Buried under all this rhetorical chaos was the deletion of a doctor-patient conversation and ensuing decision making.

Of all the losses in the culture wars promoted under the banner of a pandemic, I think the changes to informed consent, as applied to healthcare conversations, is the most profound. To dismiss the rights and powers of the patient to participate in their own healthcare fails to adequately serve the needs of the patient. It is also morally unjustifiable.

Hope For

Forever the optimist, we have seen how human communication was revised recently. That being said, I trust that the power that brought such changes about will also be able to revise it back in the other direction with time and guidance.

Our awareness of our surroundings, and our innate understanding of one another, are the tools by which we can correct some of our changes. There is no going back to where we once were, but we can always rebuild and improve the design.

There is always hope for us to do better.

Always.

“Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.”
― United Nations, Universal Declaration of Human Rights