Question

What has changed since the days when "doctor knows best?"

Answer 1

" Who is responsible for my patient? Where the hell he is"

This is quote which is often heard in every healthcare organizations providing care to people. In past decades, the doctors were considered to be the sole person to make all the decisions pertaining to the health and treatment. This developed the culture " doctors know the best ".

But since 1996, this has changed significantly. The decision making is now not only concerned with doctors but the patients as well.This is called " Shared decision " concept. The patients have equal right to participate in the decision making about their course of treatment.This concept of shared decision making fosters better communication between doctors and patients. The palliative care team can openly discuss the issues of prognosis and dying. These concepts have reduced the legal implications on the hospitals.

Earlier the use of consent was not valued. But the change in "the doctor knows best" culture, have lead to increased use of consents.The doctors have to explain all the available options for treatment and it will be patients who will decide which treatment they want to undergo. The consent has to be explained by the doctors and should be signed by the patient before any procedures. This serves as a evidence of the care rendered and also serves legal purposes.

The "doctor knows the best" culture forced people to adopt those options which was convenient to doctor and which they considered was best for their patients. This led to use of unnecessary diagnostic test, duplication of test, unwanted surgeries. But with "shared decision" concept,it has provided aids to better understand the choices and options available for treatment and also to receive a cost effective treatment.