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The Precarious Physicianpatient Relationship Return to Compassion

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The Precarious Physicianpatient Relationship Return to Compassion
The Precarious Physician/Patient Relationship: Return to Compassion
Tory Skaathun
Northeastern Illinois University

Abstract
Changes in healthcare over the past half century have altered the dynamics of the psychology of the patient/ physician relationship, resulting both increased patient suffering and moral distress among caregivers. It is the premise of this paper that this discord is now dissipating as both patients and caregivers are seeking a return to more compassionate medicine.

A construct of societal changes have caused health care to evolve. In the last 20 years the patient /physician relationship has shifted from that of a trusting long term relationship to one of frustration and alienation. Historically medicine has shifted in the past century from home based medicine to institutionalized medicine. Previously, family members tended to the ill as best they were able with the resources they had in their own homes. Physicians, when they were involved at all, commonly made house calls. Babies were most often delivered at home and most patients died at home rather than in the hospital. Interestingly, in his book Illness and Culture, (1998) David Morris contends that changes in medical care response came about as a response to the postmodern era. He sees illness as a societal state of affairs.
As hospitals grew in number medical care slowly became more institutionalized. Initially the physician patient relationship remained unchanged. In his article Modern Technology and the Care of the Dying ( Thomasma & Kushner, 1996). Ronal Cranford suggests that by the 1940’s patients began to have greater access to neighborhood doctors. Typically these doctors had a standing relationship with patients for long periods of time, and the same physician cared for most family members. Services were provided on a self-pay basis by patients. Sometimes payment included the barter system, and it was not unusual for doctors to offer charity services. The result of



References: Ansell, D. A. (2011). County: Life, Death and Politics at Chicago 's Public Hospital. Chicago, IL: Academy Chicago Publishers. Cassell, E. J. (1991). The Nature of Suffering and the Goals of Medicine. New York, New York: Oxford University Press. Chen, P. W. (2007). Final Exam: A Surgeon’s Reflections On Mortality. New York, New York. Vintage Books Groopman, J Groopman, J (2004) The Anatomy of Hope; How People Prevail. New York, New York. Random House Kleinman, A Lewis, S. (1994) Hospital: An oral History of Cook County Hospital . New York, New York. New Press Mohrman, M Morris, D. B. (1998). Illness and Culture in the Post-Modern Age. Berkeley, CA. The University of California Press. Spario, H., & McCrea Curnen, M. G., & Peschel, E., & St. James, D. (Eds.). (1993) Empathy and the Practice of Medicine: Beyond Pills and the Scalpel. New Haven, Conn. Yale University Press. Thomasma, D Vaux, K. L., & Vaux, S. A. (1996) Dying Well. Nashville, TN. Abingdon Press.

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