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Melanie M. Brandabur, MD

Melanie M. Brandabur, MD

MAY 23, 2013 | by Melanie M. Brandabur, MD, MDS, Clinical Director, The Parkinson’s Institute | There are many styles of Physician/Patient interaction. Historically, this has evolved over many centuries from a time when a doctor basically attended and comforted the patient, to more recent times when doctors are supposed to be the all-knowing providers of cures for any disease.

Along the way, possibly because doctors did gain the ability to cure some diseases, certain types of cancer, infections, fractures, etc., some doctors acquired a bit of an attitude and became accustomed to delivering care in a rather autocratic manner.

The patient was assumed to be relatively ignorant and unsophisticated and was simply told what to do, often without information as to the possible benefits, side-effects or other options for treatment. This has, for the most part, changed dramatically over the past few decades.

Today’s patient is often extremely well-informed, thanks to the internet and other sources of information, and many physicians have embraced this change, recognizing that an informed patient may lead to a more productive discussion, better adherence to the treatment plan and more reliable feedback about results. In other words, a more ‘equal’ partnership is likely to improve treatment outcomes, which is the shared goal of both parties.

In my many years of treating persons with PD and their families, I have found that this ‘partnership approach’ is a much more satisfying way to practice medicine. I genuinely want to see the articles, notes and clippings my patients bring in. These exchanges give me a chance to put new study reports or ‘breakthroughs’ into perspective, put misconceptions to rest and to help my patients avoid dangerous or unproven therapies. In addition, I often learn something new myself!

Occasionally, patients are confused by this at first, especially older people who are perhaps accustomed to a more ‘dictatorial’ approach. I may offer several therapeutic alternatives, and then hear “Well you’re the doctor!”. Most patients like having more of a say in their management, however, and I believe it makes the relationship more satisfying for both parties.

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