What makes for an ideal doctor-patient relationship?

Understanding how doctors and patients should treat each other

- DR. EDSEL MAURICE T. SALVANA

Not long ago, we admitted an elderly man who had a laundry list of medications which the medical resident (a doctor training to become an internist) on duty faithfully reproduced on the admitting orders so that he could continue taking them while he was confined in the hospital.

A few hours later, the patient's blood pressure plummeted, and he had to be transferred to the intensive care unit. Fortunately, he survived. Upon further interview, the man sheepishly admitted that he had not been taking his medications properly, including three antihypertensive medications at near-maximum doses.

In the old days of medicine, the relationship between doctors and patients was seen as patriarchal. The doctor had near-godlike knowledge, and the patient would follow whatever he or she said. There was no internet, and the only way a patient could do “research” was to hit the library and look at medical textbooks, which were written in highly specialized language but were almost always a few years behind the latest scientific breakthroughs.