Four for four: Candidates for CMA president on the move toward patient-centred health care


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  1. sam plover

    I like the responses from the doctors, but it does bring to mind, does that philosophy actually pan out in the way it was worded or how I perceive said philosophy, in the clinicians office?
    To be not heard is a horrible feeling, it results in frustration, doctor hopping, becoming the dreaded squeaky wheel and often results in profiling of the patient which is wholly legal and leads to very poor care across the board. It is a dangerous thing to get the ‘wrong’ doctor with the wrong attitude right from the get-go.
    When you meet an argumentative, fearful, distrusting patient, doctors become defensive instead of lowering their ego just a tad to see WHY this might be. To continue misunderstanding the patient, to take what another physician has written as a universal biblical truth is insane and leads to nothing but fragmented care, if we can call it care.
    And patients are left powerless and emotionally distressed which is obviously great for their health.
    Doctors generally know nothing about a patient and their interpretations of a patient on a psychosocial level are usually dead wrong. You can not know a patient from a 10 minute visit. Best thing you can possibly do for a patient is scribble the word “anxiety” on their/your charts. That is very helpful in getting care.
    And THAT is where accountability should come in.
    I believe if doctors become mensch, eventually so will the patient. Your patients are informed, especially if they have chronic disease. They are often more informed if they have received questionable care, since they research for answers from reputable sources, which often doctors have no time for.
    Listen to what the patient is saying. Most want to live and want to live a half decent quality of life. Don’t ruin your patient’s care by scribbling untruths, or half truths. Don’t add to their distress. It is a prison that patients cannot escape from and it is power you hold.
    Egos should not come in the way of care for a patient, even if said patient is slow in getting on board.
    Medicine is not for me and I did not choose to care for others in that way. But it was your choice to become a doctor and it is imperative to form a trusting relationship and that might take time. But it is done by following latest guidelines, realizing you have no power to heal people, realize science is only in infancy and death happens.
    The life or death of a patient should be a holistic space for the patient and family. Nothing worse than to leave a suffering patient to ER care and turn your back at the last minute.
    I speak from experience and it is very difficult to get a doctor to relax enough so he trusts you. He is so bound up in the psychological aspects he/she learned in school, and so fearful of a ‘manipulating’ patient, so guarded in his ’emotions’……all those things learned in med school are in the back of his mind, while the patient is speaking. Don’t judge from a tunnel vision, when a patient is literally begging to connect, don’t be afraid to let your so called guard down.
    No patient benefits from unshakable doctors. And you have no idea what that results in in the long term.

    • Darren Larsen

      Sam, this is a brilliant analysis of exactly what it feels like from the patient perspective and I am so glad you took the time to present it. It is great to know that we feel the same about this. Patient centred care is about relationships. It is about trust in both directions. It is about how we communicate, in listening especially, but also in how we talk. “Nothing about me without me” is not just a phrase. It is a philosophy. And for those of us who are clinicians who have been on the other side of the desk, we understand the issue completely. This is something that I, together with CMA, will stand behind in all the conversations I will have.

  2. Kathy Smith

    Your summary statement is spot on. A “Relationship-centred” philosophy ensures optimum patient/provider satisfaction – healthy “chi”.

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