Monday, November 19, 2007

When doctor's hate informed patients

A doctor, Scott Haig, published an essay in time magazine titled "When the Patient is a Googler" on November 8. The doctor describes a prospective patient who is "well spoken and in good shape, an attractive woman in her mid-40s." He then says that she "launched into me with a barrage of excrutiatingly well-informed questions."

In the course of the essay, Dr. Haig describes Susan's child as a "little monster" and her as a "brainsucker." He says patients like Susan are full of "half-baked ideas" and are suspicious and distrustful. He also says that patients like Susan are full of "misused, mispronounced words and half-baked ideas" (what happened to her being "well spoken" and informed?) He knew these things about patients like Susan not because of anything she said (she was well spoken, after all) but because "a seasoned doc gets good at sizing up what kind of patient he's got." He decides not to treat Susan but to refer her to another doctor. When he declined to treat her, he says she was "disappointed and annoyed," but she already had an appointment with the doctor he planned to suggest.

It is obvious to anyone but the doctor that she was vetting prospective doctors just as he was vetting prospective patients. It may be that knowledgeable patients get good at sizing up what kind of doctor they have. Based on the essay, her questions were a good way to ferret out a megalomaniacal doctor who could not handle a patient who may know a little too much. He asks whether such patients exist in countries where doctors are in short supply. It is possible that Susan is a selfish prig who wants everything in life on her own terms.

It does not appear, however, that Dr. Haig is one of those doctors who travels to a war-torn country to give his services to those who need them most. Nor does it appear that Dr. Haig has any humility in the face of patients who may know more about their own pain than he. Susan isn't the only patient Dr. Haig doesn't like, you see. He describes others as "non-compliant Bozos." This is a doctor who gives orders and expects them to be followed.

Paternalism, indeed, is not dead.