Will the doctor listen to my views on how my case should be managed?

If you understand your options and re quest an approved treatment, it is reasonable for your doctor to agree provided that this treatment is available locally. There are occasions when a patient re quests a treatment but the doctor has misgivings and may feel unhappy to proceed with it.

Patients expectations are increasing as a result of media coverage and political involvement (such as 'The Patient's Charter'). Despite our best endeavours, there are times when patient satisfaction seems less than we, as doctors, would have anticipated. Physicians have an absolute responsibility to assist their patients to the best of their ability but success can only be accomplished in partnership with our patients; we cannot insist on patients accepting our advice.

The partnership between patient and doctor is a special one. Both share the desire to see you safely through your problems in a caring and efficient manner. It is clearly not a partnership of two e Quals pooling resources such as two doctors sharing a practice. Ultimately, only you are in a position to know how much your condition is affecting you and how far you wish to pursue investigation and treatment. Furthermore, however much you read on the subject, it is your doctor who has had the appropriate extensive background education, who has seen many patients with similar problems to yours and who continues to keep abreast of current advances and their limitations.

High quality physician-patient communication lies at the heart of medical practice. The medical profession has always acted in the best interests of its patients. For previous generations, it was accepted that the doctors were the experts and decisions made by them should be accepted without question. Patients were effectively shielded from the decision making process. In an ever-increasing way, patients have appropriately taken a more active role, and perhaps the ideal is reached when the relationship becomes one of partnership (Figure 4.2).

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Figure 4.2 Patient Doctor Partnership - BMJ Front Cover 1999

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