Prof. Dr. Irany Novah Moraes
Never has medicine had, as it does today, so many resources to diagnose and treat the sick; and yet never, too, has there been so much discontent!
Physicians are deeply concerned about the growing dissatisfaction of patients. The number of complaints increases every day. Any dissatisfaction on the part of the patient or their family is given, by the media, a blind welcome, without the slightest caution: a great scandal is set up and, a priori, they condemn the physician to the maximum penalty, killing him civilly and professionally, without any right to a defense, without even clarifying whether an error truly occurred and whether he is the one really at fault. In flagrant arbitrariness, through generalization, they defame the entire profession. The cases that reach the Medical Councils and the courts reveal that, once the “wheat has been separated from the chaff,” the truth is otherwise. The accusation is often empty! And yet there is not the slightest concern to correct the departures from the truth.
It seems paradoxical for someone to mistreat, in advance, the very person to whom they are about to entrust themselves in order to relieve their suffering. Some patients arrive at the office with a preconceived attitude, revealing a subtle hostility. It was never like this! The physician was always treated with respect, affection, and gratitude! The patient would refer to the physician and say with pride: “my” doctor! Today they rarely even know his name. Things have changed; complaining seems to be the order of the day. This has troubled those who have lived for medicine and who now find themselves faced with anticipated discontent. What will the doctor-patient relationship be like for the young people entering the profession today?
An analysis of this problem suggests some points that explain, but do not justify, what is happening. That is what I propose to do below, highlighting three points.
First — no one goes to the doctor or the hospital spontaneously, but only because of something that worries them a great deal, and never to the emergency room unless they are suffering — most often the reason being pain, bleeding, or shortness of breath.
Second — with the advent of the Consumer Protection Code, citizenship, which was not part of our people’s culture, is being reclaimed through an approach that makes indiscriminate use of complaint. There is no thought of building it up through education, of winning it in a sustainable way! Thus, many people think that the watchword is to complain!
Third — although striving in the same direction, the objectives of the physician and the patient are different. The physician’s is to care for the patient and not necessarily to cure them; whereas the patient’s is always to be rid of the disease. The physician knows the limitations of medicine, but the patient does not believe in that reality, for he watches on television surgery performed on a fetus in the mother’s womb and cannot understand how, in his own case, the disease is incurable!
To conclude, I believe it is essential to reverse the situation, and to do so we must restore the trust that is needed to ensure the good doctor-patient relationship undermined by emotional strain and the limitations of medicine. This is everyone’s task, but only the media has the power of mass communication. It can make everything clear so that the truth is not evaded and everyone understands that Galen’s maxim holds true: “he who has the patient’s trust cures best.”
