Remo AguilarRecently, I’ve been receiving complaints from patients regarding some attending physician’s “quality” of service. Complaints like, “the doc saw me late already” or “my waiting time is far longer than my physician encounter time” or “this was not explained to me” or the difficulty of some patients (or relatives) to talk to their physicians. In most cases, the attending physician’s technical competence is unquestionable, but the patients or relatives sometimes felt they still didn’t receive adequate care or service from their physicians. What must they do?
I always tell these “complainants’ that any doctor-patient relationship is contractual by nature. Meaning both parties has to agree and deliver their end of the deal to consummate the “contract”. The contract is of course the delivery of health services required by the patient’s current health needs.(Read my perspective of this here.) This may sound simplistic but for purposes of discussion, this “understanding” of a contract should suffice. If one party, does not agree or adhere to the contract, then the relationship could be terminated after due process.
In non- emergent situation, and if the service is available, patients have the choice on who will be their doctor or what type of service they could avail. That by choosing or agreeing to be under the service of a particular physician, the patient also has the responsibility of paying the services of that physician. That is the contract, no matter how business like it sounds. In cases where one party felt that other party did not deliver the expected service , he or she may choose to end the contract after duly informing and after paying the services rendered by the physician. (By the way, the physician under certain circumstances and on valid grounds, may opt to terminate a patient-physician relationship too but let’s leave that discussion in my future posts.) In my practice, I always offer this option to all my patients even prior to our patient-physician relationship.
Problem comes in when patients just change physician services without adequately informing their previous and frequently, their succeeding physicians. Far worse is the situation wherein patients “leave” their previous physicians without paying their bills on the pretext of a “bad” service. This is not good practice either and probably will only harm patient’s reputation also. In the first place and except in emergency situations or some government health training facilities, the choice of any physician is really the patient’s responsibility. Health is the business not just of the physicians and institutions but of the patients as well. If you don’t know any of your physicians in the community, then you cannot blame someone else for receiving a bad service. Remember, that physician gave his or her professional service and in the context of a contractual form of relationship, that has to be duly paid even if you’ll change physicians.
So if you want to change your attending physicians for a valid reason, inform your physician of the transfer. Pay your end of the contract, meaning the services rendered. Cultivate the habit on talking to your doctors. Pour in your concerns on them and seek necessary answers to lingering questions. But don’t forget to inform the physician if there’s something good also about his or her service that you liked. I always believe no doctor would want any patient to feel bad about their brand of service. Just be honest. If those physicians do not change for whatever reason, that’s their catch. Remember that health community is far more sensitive than we thought on issues like this. These type of service screw ups always catches up someone else ears. If you don’t like them, then do not patronize them. That way, you won’t complain at the end of your contract. That simple.
Or is it? What do you think?
“The essential quality of the clinician is an interest
in humanity, for the secret of the care of the patient is in caring
for the patient.”– Francis Peabody Class of 1907, Harvard Medicine
Well-said! I've seen firsthand how patients "abuse" this contract. Sadly, most patients are not aware of this contractual relationship. Too many times I've seen patients and their relatives demand services from a physician and after services have been rendered, fail to keep their end of the bargain. Surgeons are especially vulnerable to this.
On the other extreme, there are patients who demand a physician to be on their beck and call just because they are paying for his/her services. Dios mio, their treatment to their doctors is akin to a master's treatment to his slaves!
I love our job, or should I say vocation, but when patients get difficult or when you get zero PF after making a patient get well, I get to thinking that I should have chosen a career that doesn't involve…living things.
Certainly there are cases that fall into the type of patient you're describing anakat. In both examples, our profession is reduced to the same business routine services. These are the kind of patients whose education are wanting and pose a challenge to the medical community. Call it the hazards of the profession. But of course, we have no hazard pay right?
sad to hear that you think you’re just a slave to the paying patients. just want to candidly ask this, no feelings involve, hehehehe First, a patient consult a doctor to find out what causes the ailment/disease with so much hope of curing him. imagine a patient paying the doctor by just telling him to get this laboratory/tests and comes back with the result and pays the doctor again. it is okey if the prescription cures the patient what if not, do you consider then that the “contract” is consummated. what about the hard earned money we paid. have you encountered a patient asking for a return of his money because of misdiagnoses, what’s worst is if the uncured patient returns and another fee is collected. looking for another doctor entails another cost.patients demand whats their money’s worth, but majority are just reluctant listening to the assumed learned doctors. why is it so normal for doctors to let their patients wait in their clinics for hours, why not change their schedule to 12:00noon instead of the usual 8:00am if they couldn’t make it. just asking no bad intentions/hard feelings meant, thanx
@GLEAN LIM Thank you for your comment. I beg to disagree. I don’t feel I feel I am “just a slave to paying patients”. A large portion of my practice involves treating patients who cannot afford our expensive healthcare system. I didn’t just encountered patients who asked for a refund of their medical expenses. I has had instances I have to foot the medical bills myself just so the patient can get home from the hospital. We do what we can do from our end.
My concept of contract here is all about the professional conduct we do in dealing with our patients and hopefully give the best service to them. Treatment in medicine sometimes doesn’t mean “cure”, often just palliative. In such cases, doctors are obligated to disclose the goals of treatment to his or her patient. Having said that, it is always a partnership between the doctor and patient in terms of treatment. The only assurance you will have is that you will have to both strive to find the best care treatment you both agree upon.
I always wanted a patient who ask around, search about, the next doctor he/she wanted to enter a contract with. A well informed patient is a very good patient. And will keep you away from entering into contracts with physicians who does what you mentioned in your comment above…:)
thank you, hope we will have more doctors like you, with the expensive health care we have in the phils, patients deserve better service, we are not suppose to ask for it, it should be given outright. sorry for my comment, but i experienced this in St. Lukes QC, I had been to many doctors in Cebu yet i was not relieved so i went to St. Lukes, which many think is the ultimate cure/hospital, thus the doctor acted like GOD, but my condition did not improve. i think St. lukes is overrated.