The New York Times Health blog highlighted an article in this month's Annals of Internal Medicine. Dr. Faith Fitzgerald recounted in an essay her struggles to get a hold of another doctor. The exercise in futility causes her to reflect on how difficult it must be for her patients, or any patients, to contact a doctor when they need one. The culture of medicine is such that the doctor is protected from being "bothered," even by the patients who need him or here. When a patient does get through, he or she may feel the need to apologize to the doctor for being a bother, when really, it is the doctor's job to listen to the patient. The blog is here, but the link to the article requires a subscription: http://well.blogs.nytimes.com/2008/03/17/bothering-your-doctor/.
With all the other time pressures and power differentials, even the culture surrounding the doctor makes it difficult for the patient to even approach the doctor with a question, let alone engage in a meaningful dialogue.
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