‘The patient will see you now’

I heard an expert patient talking to a group of healthcare professionals this week. She said I have learnt to be a ‘doctor centred patient’.

Monday, 12th April 2021, 3:47 pm
Updated Monday, 12th April 2021, 3:52 pm
Dr Ollie Hart donning his PPE at Sloan Medical Centre

It was initially a bit chilling, as she explained the trouble it had caused to be labelled a ‘problem patient’.

As someone who takes a very active role in looking after herself, she had experienced doctors can get defensive or be intimidated by patients who know more than them, or who are very clear about what they want.

It was quite a clever twist on the phrase ‘person-centred care’, a term often used in health care circles. This very articulate lady was opening a health conference on the topic of person-centred care. She was highlighting that often patients can be forced into tip-toeing around the doctor to ensure they get the best out of the professional. You could see this as a sad reflection on the ego of many healthcare professionals, but I think it highlights the importance of considering the relationship at the heart of the best kinds of care.

Dr Ollie Hart, Sloan Medical Centre, Woodseats

For any relationship to work well its generally best for there to be a level playing field. If one party is way more dominant than the other, I think it disrupts the subtle magic of human connection. Although we might assume the healthcare professional should be the ‘dominant’ force, there is a risk you lose the benefits of the mutual exchange of ideas, thoughts and feelings.

The American psychiatrist Stephen Karpman famously describes his ‘drama triangle’. He noticed people often fall into one of three roles in relationships, rescuer, persecutor or victim. You can see how the professional could take on the rescuing role, “don’t worry, I’ll tell you what to do”, or the persecutor “you’re not looking after yourself!”. But it can be the other way around with patients jabbing a finger at the doctor, “you’re not doing anything to help me”. There is no healthy place for anyone in the drama triangle.

So it makes me reflect that if doctors are seeking to be patient-centred, and patients are seeking doctor-centred, we are generating healthy relationships. It becomes a respectful two-way process, where we get to know each other, and understand how to work best together.​​​​​​​​​​​​​​​​​​​​​​​​​​​​