Sunday, March 15, 2020

Doctor-Patient Relationship Needs John Adams

In 1770, in Boston, British soldiers fired into a crowd of colonists who were taunting the soldiers.  Several colonists died and several soldiers were arrested and charged with murder.  This event known as the Boston Massacre was a seminal historical episode that contributed to the colonists’ growing desire to separate from the British Crown.

Boston was a cauldron of the independence movement.   Hatred against the British was prevalent.  Who would be willing to defend the accused soldiers at trial risking opprobrium or worse?  John Adams, our future second president, defended the soldiers believing that every accused deserves adequate representation.  To this day, America distinguishes itself with our belief and practice that an accused man is presumed innocent and is entitled to a competent legal defense.  As we all know, lawyers are often assigned or volunteer to defend unsavory individuals to protect their clients’ constitutional rights, ensure that the legal process is being respected and to prevent a rush to judgement from taking hold.  Understandably, many lawyers would not rush to defend accused child molesters, terrorists, white supremacists, kidnappers or abusers of the elderly or other vulnerable people, and yet these accused people fully deserve and are entitled to representation. 


John Adams Sets Example for Doctors

But, John Adams accepted defendants who were reviled and thereby burnished his own reputation as a principled statesman performing the noble mission of the legal profession.  Six of the soldiers were acquitted and two were convicted of manslaughter.

Both lawyers and physicians don’t choose their customers.  They come to us.  While many who come to physicians for assistance are pleasant and cooperative, others have less sanguine traits.  I have seen patients who are argumentative, demanding, rude, dishonest, hostile and overtly racist.  A few days before writing this, one of our secretaries became rattled when a patient cursed her. Of course, patients who are worried or sick are entitled to great latitude, which doctors and our staffs extend to them.  But, aside from this, there are disagreeable patients whom I just don’t like.  But, these folks are entitled to the best medical advice I can provide, and I do my best to meet this obligation.  Everyone has a right to competent medical care.  But, as doctors and nurses would testify, it is easier to do our jobs when patients and their families are pleasant and cooperative.

First, let me admit that not every physician is a clone of Marcus Welby, MD, and patients may legitimately complain that some of their doctors are wanting in their bedside manners and attitude.  If readers wish to speak on this issue, leave a comment.

There is no application process to become a doctor’s patient.  Universities and employers can reject applicants, but physicians, for the most part, see everyone.   While I like and enjoy the majority of my patients, there are some whom I serve despite harboring some negative feelings.  And, of course, even those whom I enjoy being with may have a variety of private views and opinions that differ from mine.  Part of my job is to make sure that any personal feelings I have do not interfere with my ability to serve the patient well. 

I’d like to think that I could serve any patient, but I recognize that this idealistic statement is not realistic.  Humans cannot be expected to exhibit superhuman behavior.  If the doctor-patient relationship is strained beyond the point where the doctor can give sound and sober medical advice, then the physician may need to step aside. 

John Adams has set a stratospheric example for lawyers, physicians and, indeed, for all of us.


2 comments:

Tarigal said...

In the same vein as John Adams and Boston's wish for independence...relationships are made better the more freedom is in that relationship.

How much freedom is in the doctor patient relationship? On both sides

Michael Kirsch, M.D. said...

@Tarigal, appreciate your comment. I agree that freedom and openness make for better relationships and outcomes. Look forward to your returning to the blog.

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