A Doctor's Point of View on the Doctor Patient Relationship

Many of our questions and comments on MS Health Central illustrate the growing strain between doctors and patients.  Perhaps this is due to the fact that patients expect more from their doctors nowadays.  And add to this the plethora of information anyone can glean about their medical conditions from books, magazine articles, television shows, and of course the internet.  We see several episodes of "House" or "Scrubs" and we think we too can possess the medical knowledge of a doctor.  In some ways patients feel more confident and assured to take charge of their medical conditions.  But somewhere along the way, it is my opinion that we have lost trust in our doctors and in the medical profession. 

If you have a disease such as Multiple Sclerosis or even if you are in limbo and awaiting some diagnosis to explain your symptoms, it is essential to have a good relationship with your doctor or neurologist.  Let's face it, you are going to be seeing the doctor for a very long time.  It is critical that you find someone who you can work well with and with whom you feel a certain degree of trust. 

I have asked Doctor Nitin Sethi to contribute to this discussion through an interview about this very topic of the doctor-patient relationship.  Doctor Sethi will discuss this relationship from a doctor's point of view and in part two of this series we will examine the same relationship from a patient's perspective.  The patient will be me.   I do encourage you to offer your viewpoints through the form of comments to these articles.

I introduce to you:  Nitin K Sethi, MD who is the Assistant Professor of Neurology at New York-Presbyterian Hospital of Weill Cornell Medical Center located in New York City.

What do you feel are some of the personal qualities which are important for a doctor to develop rapport and trust with patients?

A lot has been written about doctor patient relationship and what qualities define it. Nowadays in medical school itself there is a thrust not just to produce smart doctors but also to produce more humane doctors. A study had shown that student doctors (medical students) have the highest levels of empathy. As they go through their long training (residency and at times fellowship), this empathy progressively decreases. One may argue that "experienced" doctors become less humane. I do not buy that argument. I feel the empathy gets replaced by knowledge. You know what you are dealing with and you understand disease pathology better. This might make a doctor sound aloof and like a "machine".  He is very good at what he does but he is cold and aloof.

My patients frequently tell me that they left their previous doctor because he would not hear them out or he was not caring enough. They rarely say I left him because he was incompetent. I want to make this point to answer your question. Some of the smartest doctors I know (people I would go to if I had a neurological problem) do not have the greatest bedside manners. They are not most suave. But as a patient I would rather go to a competent doctor than to one who says all the right things in the right way but is not the smartest light.