Rethinking doctor-patient relationships in a digital era
Though we live in a digital era, most patients reportedly leave their oncologists’ clinics with several questions unanswered. Prof. Louis Denis, M.D. FACS gives a re-think about the relationships
A great deal of patient dissatisfaction and several complaints are due to breakdown in the doctor-patient relationship. The age old bond between the treating physician and his patient, aptly called ‘le colloque singulier’ is simply lost in the explosion of our oncological knowledge and the proven subsequent need to multidisciplinary medical treatment and multiprofessionality in providing holistic solutions. Should the oncologist be blamed?
With the evolving complexity of cancer at different levels, communication and collaboration between doctors and patients become extremely essential in treating any cancer according to evidence based criteria. Guidelines and monograms ease the direction of the treatment but apply to cohorts of cancer patients and not necessarily to individual patients with unique genetic make-ups and specific psychological, social, financial and spiritual needs. Should the patient take the blame instead? The question of who is to be blamed is often unrequited.
It might be extremely difficult – both for the patient and the doctor – to handle the initial phases of diagnosis of cancer. To the patient, it might often read like a death sentence or at the least a drastic change in lifestyle. In the current healthcare climate, both doctors and patients have very little time to communicate and recover from the initial shock. The patient never gets sufficient time to fully come to terms with the medical situation and is often forced to quickly learn the nitty-gritty’s, initiate a dialogue with the treating crew and express their autonomy in a shared decision to initiate the cancer treatment and survivorship.
Holistic cancer management unquestionably requires a well-established balance between tumor-centered treatment and patient-centered care. The tumor-centered treatment is multidisciplinary in nature, essentially based on evidence and forms the scientific base of cancer treatment. Patient-centered care, on the other hand is the multiprofessional aspect involving psycho-social, financial and spiritual expertise and is focused on the patient.
Often, the patient comes first before his cancer.
The doctor-patient relationship itself is a strong drug! Furthermore, personalised medicine and individualised treatment routines are particularly crucial in successfully diagnosing and treating cancer, as treatments often differ based on the characteristics of the tumour and its genetics.
We are entering a new era of cancer treatment with unlimited expectations. Without any doubts, it will take many years to see this tailored treatment become mainstream. We should be aware of this evolution, move into clinical trials and support further research.