Expectations: What Can Your Doctor Do For You?
Dr. Robert Maddox is in his second year of Family Practice Residency training in Florence, S.C. He is a ruling elder in Faith Presbyterian Church, PCA.
Frustration is often a result of expectations that remain unmet. We expect a product to work for a certain number of years and it fails to do so. Or the people in our church just won’t work as hard as we expect them to work. Or the promotion we expected did not come. Expectations. They say a lot about our values, our beliefs, our desires.
Most people have expectations of their doctor. The personal pronoun “my” that generally precedes “doctor” reveals one expectation. He is expected to be available to that individual in the time of need. He will not abandon “his” patient. There is a contract not well defined by law, but which carries much weight, even in a court of law. For example, a doctor may be guilty of abandonment if he withdraws from the relationship without timely provision of a suitable alternative source of medical care for his patient. Very rarely, though, is a contract explicit between the doctor and the patient. And the implicit contracts of both the patient and the doctor contain expectations that often lead to confusion or frustration.
When asked their expectations, few patients verbalize a complete contract. Most state they want competence and compassion, in some ratio. Almost all expect, perhaps unawares, complete relief from their suffering, if not the removal of the cause. Ultimately, a person wishes that he could be restored to his pre-sickness condition. And all of this would ideally be accomplished without any effort. In short, most patients expect the doctor to cure them.
Traditionally, the role of the doctor was more of a teacher. This is the meaning of the word “doctor.” The “physician” was one who could understand and manipulate “nature” or “physics” to cure a person. Magical cures were expected of the latter, whereas the former was looked to for a better understanding of what one would undergo as the disease took its course. Medicine today, with its technological wonders, is generally expected to produce cures. Few patients are satisfied simply to know how long it may take for them to get better.
Can the profession meet these expectations? Certainly there has been progress in curing some diseases (usually amelioration, rather than cure). Some cancers can be stopped, some infections eradicated, some malformations fixed. But the limits of medicine are rapidly being realized, both by those within the profession and those without. The medical profession has made very little impact on the survival or health of the population in general. People live longer and are healthier now mainly because of improved living conditions and sanitation, not because of the magic of medicine. High technology helps only a few people to gain a few useful years, in general.
Even when medicine has an effective intervention, most patients expect the doctor to work the magic and expect to do little or nothing themselves. This is manifest in many ways: the man who continues to smoke, ever. during hospitalizations for shortness of breath; the workman who breaks a leg and wants to be back to work in a day or two; the diabetic who keeps getting bad infections on his feet but will not wear shoes to protect against the minor injuries which lead to infection. Such mutual failure to meet expectations is a major source of frustration for both the doctor and the patient.
So what can a patient expect from the doctor? To answer this, it is necessary to review why we are ill. There is illness due directly to our sin (e.g., sexually transmitted disease in someone who fornicates). In these cases, we can expect the doctor to show us the link so that we can repent of that sin. Other times, illness is due to our neglecting good habits, such as proper sleep and diet. Hefe we can expect that doctor to remind and teach us how to stay healthy. Some illness is brought on us simply to display God’s glory. The doctor can be expected to comfort and console through this illness. In each of these situations, the patient can reasonably expect the doctor to use whatever skills and medicines might relieve the symptoms or consequences (except perhaps when one is unrepentant of the sin causing illness). Expect also that the doctor teach you regarding not only the cause of your illness, but the nature of it. You are responsible for your body and its functioning and it is you that must give an account to God. Seek to understand what you can about your illness.
Remember that the contract is two-sided. The doctor can expect you to follow through with the treatment agreed upon. He can also expect you to tell him the truth. If you want him to make responsible and helpful suggestions to you, you cannot tell him you have been taking the medicine as prescribed, if you have not. Also, when you are actually afraid you may have cancer, tell the doctor this, rather than only mentioning a symptom. Telling the doctor straight out makes his job much easier.
Make it a practice of talking to your doctor about what you expect of him and what he expects of you. This will lead to a more profitable relationship, in your best interests. And if your doctor is not a Christian, either seek one who is, or use these discussions about your expectations to proclaim the gospel of Christ, And may God grant you good health, to the praise of his glory.[ JBEM Index / Volume 2 / Number 1 ]