Chapter 83 Potential Conflict between Patient Care and Systems-Based Practice Competencies
You walk into the examination room, introduce yourself to Mrs. Smith and her family, and sit down to begin reviewing the pertinent medical details of Mrs. Smith’s condition. This is a familiar encounter in our health-care system that occurs thousands of times per day. In the purest sense, this is straightforward. You are there to serve Mrs. Smith’s needs for care, providing appropriate information and arranging for further testing and treatment as required. The patient’s expectation is that you will do everything possible and appropriate to treat her without concern for cost. When you are sick, it’s no time to start cutting corners, correct? And besides, she’s well insured. The cost of her care won’t come out of her bank account.
There is nothing more important in health care and health policy than the patient-provider relationship. Hence the dilemma of the individual’s need versus the community’s need requires conscientious communication and concomitant interpersonal skill. Communicate effectively with your patients, advocate for them with insurers and employers, and be a knowledgeable spokesperson for the vulnerability of the “doctor-patient” relationship in our evolving health system.