Are You Afraid to Talk to Me?


A couple of generations ago medical culture was aloof and authoritarian. Doctors did not give advice to patients, they gave orders. Patients were expected to follow those orders. Questions might have been tolerated, but patient requests for explanations or suggestions for a different approach were considered very unusual.

I thought this paternalistic model of doctoring ended long before I was trained. I was trained to think of the patient’s autonomy as the core of the patient-doctor relationship. I was taught that I should explain various alternatives, answer questions, and allow the patient to make the final decision directing her care. Doctors were expected to make recommendations, but also to encourage questions, second opinions, and exploration of alternatives.

I guess old habits die hard. A ” target=”_blank”>Afraid to Speak Up at the Doctor’s Office (Well, the NY Times health blog)
” target=”_blank”> Authoritarian Physicians And Patients’ Fear Of Being Labeled ‘Difficult’ Among Key Obstacles To Shared Decision Making (Health Affairs, abstract available without subscription)

Important legal mumbo jumbo:
Anything you read on the web should be used to supplement, not replace, your doctor’s advice.  Anything that I write is no exception.  I’m a doctor, but I’m not your doctor.