May 15, 2015

Which Is Best, Paternalistic or Maternalistic Care?

Be careful with this choice, as both can be good and both equally bad. The author of this is a woman doctor and she feels maternalistic care should be better. I have experience with both and there are advantages to either male or female doctors and there are some very serious disadvantages. Some doctors have advantages based on the type of medicine they practice.

Problems for both sexes:
  1. Avoid either sex when the doctor talks at you or leaves you out of the discussion.
  2. Avoid either sex when the doctor hands you a prescription without any explanation.
  3. Avoid either sex when the doctor fails to give you clear instructions about medication side effects.
  4. Avoid either sex when the doctor does not give you a copy of your lab results and does not explain them to you.
  5. Avoid either sex when the doctor does not listen to you about the problem you are trying to explain. Keep to the facts as you know them and don't add drama to the facts.
  6. Avoid either sex when they bully you or boss you around to get the results they desire. Avoid tests when they will not explain the purpose or reason for the test.
There are many more chilling effects that the doctor can have on the doctor-patient relationship that should have you seeking another doctor. There are doctors that are plainly bad doctors, yet are still practicing medicine.

Always remember that you have little time with the doctor and if they waste the time or fail with many of the above items, seriously consider finding another doctor. Make sure they are interested in your health and providing the best care. However, remember that what you may think is the best care, may not be best for you and they should explain this to you. You also have the responsibility to listen to the doctor and then ask questions if you do not understand what you are being told.

The author uses an analogy that leaves me cold and wanting to avoid her. I am a human being with wants and needs and not a baby chick in a brood of patients for her to watch over. If she were with me every day and making sure that my medical needs were provided for on a daily basis, then I might not be so opposed the her analogy.

She says she has been taught that paternalism is not good, but feels that maternalism is the softer side and it is okay. To me they are equal and often damaging to the patient. I disagree with the author when she says maternalistic physicians do not dictate the their patients, but guide them gently in what they think best. This is the same as paternalism and you cannot separate them.

If they are good doctors, they will not be maternalistic or paternalistic, but just good doctors. They will accomplish many of the following:
  1. Good doctors will give patients autonomy, never make them feel alone, or unsupported in their care.
  2. Good doctors will care for the patient as a whole and not just the illness or problem. This will be regardless of the faults or weaknesses of the patient.
  3. Good doctors will reassure the patient they will be there for what ever they decide.
  4. Good doctors will acknowledge the patient as the unique person they are and treat them as such.

The last item above separates good doctors from poor doctors, and are the most difficult to find. Many doctors attempt to put themselves on the pedestal, but it is the great doctors that patients elevate to the pedestal. Yet it is these great doctors that know how to step off the pedestal and care for their patients as the humans they are, despite their uniqueness.

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