The General Medical Council (GMC) is the governing body for doctors in the UK (like me). The GMC publishes rules and regulations on how we doctors go about our business. Of course, the real aim of having such guidance is to ensure that individuals get a certain standard of medical care. Perhaps with a patient focus in mind, the GMC has recently published guidance on what individuals can expect from their doctors. You can read the guidance here.
One of the broad sections of this guidance is entitled ‘Doctors must treat patients as individuals’. I actually think this is an area which we doctors struggle with quite often. Certainly, I quite often hear complaints from patients who feel their regular doctor (usually their general practitioner/family physician) does not treat them as an individual. One way this quite commonly manifests is when a doctor recommends a treatment, and a patient expresses doubts about it and/or whether it’s right for them.
A classic example of this concerns the recommendation to take a statin (cholesterol-lowering drug). This may be suggested by a doctor, but I think increasingly patients are pushing back against this advice due to increasing recognition of the limited benefits and potential harms of this treatment. Many patients I have spoken to have felt ‘fobbed off’ by their doctors when they’ve raised legitimate questions and concerns about statins.
Not uncommonly, a doctor will suggest a patient is being reckless or even stupid for not taking statins. Dismissal of concerns about side effects as being ‘very rare’ (when they’re not) I think is common too. From time to time, I meet people who have felt ‘forced’ to take a statin. Some are on a statin and are fearful to stop in case of how their doctor may react.
I do not suggest people reject their doctor’s suggestions out-of-hand. But I do believe that coercion and fear do not make great bases for medical management decisions. As I sometimes feel the need to remind people, no-one can force them to take a medication (unless of course someone has been restrained and is forcibly medicated against their will – that’s perhaps a topic for another day).
The good news is that the GMC has acknowledged that doctors should answer patients’ questions and concerns properly. And that whether a patient takes up the offer of treatment is up to the patient. Here’s the relevant wording from the GMC guidance:
[box style=”rounded” border=”full”]Doctors must listen to you and respond to your questions and concerns.[/box]
[box style=”rounded” border=”full”]Doctors will tell you about treatment options that will work for you or will explain if there is not a treatment available. They may recommend one treatment option, but it is up to you to decide which option you want and you can decide not to have treatment.[/box]
I do not want to make trouble between patients and their doctors (there’s already way too much of that going on already, in my opinion). However, I have to say I find some doctor behaviour I’ve had relayed to me is shocking and unacceptable. A big part of the problem, it seems to me, is simply not respecting a patient’s views and wishes. Should this happen to you, and if you’re in the UK, then you are quite within your rights to remind the doctor of their duty of care to you as set down by their governing body.
I don’t know what the situation is in other countries. However, even if treating patients as individuals and honouring them is not enshrined in professional guidelines, I do think it’s the least patients can expect. These common courtesies make for good relationships and good medicine, in my opinion.