The Doctor, His (or Her) Patient, and Who (or What) Else. Is the Patient-Doctor Relationship Obsolete?

Don R. LIPSITT, MD

Clinical Professor of Psychiatry

Harvard University Medical School, USA

Years ago, medical technology consisted of little more than a

stethoscope, a sphygmomanometer, and an otoscope, and the doctor's bag carried only a few basic medications. How patients and their doctors related was believed strongly to influence the healing process. Contemporary times have seen an explosion of medical technology, pharmaceutical agents, surgical techniques, prosthetics, rehabilitation interventions, and other "miracles of modern science." Furthermore, the decoding of the genome and the amazing strides in neuroscience have unlocked and clarified the complexity of many diseases, resulting in improved diagnostic capabilities and treatment efficacies. We must ask whether these wonders of medical progress have led to increased mechanization and dehumanization to medical care, thus casting the importance of the patient-doctor relationship in a less relevant role. Further assaults on the relationship between physicians and their patients has been the intense bureaucratization of what is now referred to as the medical industry, with intrusion into the previously two-person transaction by insurance companies, federal agencies, and other regulatory bodies. In psychosomatic medicine, where mind-body interaction is believed to sensitively respond to the personal component in health and illness, studies of the importance of the patient-doctor relationship remain very scarce. This presentation will explore the evolving nature of the patient-doctor relationship and its relevance to psychosomatic medicine.