Issue link: https://beckershealthcare.uberflip.com/i/1489485
25 CMO / CARE DELIVERY healthcare could make those instances more common. "Every other commercial on TV is about online healthcare," Dr. Carrese said. "You can get medications for this problem or that problem without having ever seen the prescribing doctor before, and that raises concerns and questions in my mind. "e core of your care, ideally, should be with someone who knows you as a person. ere's definitely literature supporting the idea that if you know a patient better … that absolutely leads to better care." Taken together, growing access to virtual and concierge-style healthcare may begin to further shi society's view of the medical field away from one where providers are largely viewed as trusted experts to one where they are more recognized solely for providing a service or fulfilling a request. e bottom line A reflection on the evolving perception of physician-patient relationships naturally leads to the deeper question of whether prestige belongs in medicine. e answer is not so simple. "In many ways, physicians have been held up on a pedestal by their patients and by their communities," Dr. Kaplan said. "In some ways, it's affirming, and yet it also has challenges." As the past two years have shown, distrust in physicians and other health experts can significantly hinder public health efforts and complicate patient relationships, according to Dr. Kaplan. "Hopefully, the pendulum will swing back because you need the power of science," he said. "We need the power of relationships, and I think the physician-patient relationship is one that is most important." At the same time, leveling the hierarchy between physicians, care teams and patients could open the door for more shared decision- making and strengthen the patient-physician relationship. Dr. Kaplan cited the book Helping: How to Offer, Give, and Receive Help by organizational development expert Edgar Shein, PhD, which says an optimal helping relationship cannot include power imbalances. Putting physicians on a pedestal in which their word trumps all could undermine — or altogether obscure — patients' valuable perspective and opinions about their own care. "I don't want to be regarded with prestige by my patients in the sense that I'm put up on a pedestal and I'm seen as above them and more important than them," Dr. Carrese said. "I would like to be highly regarded and trusted and respected because I've earned it." ere is no better time than the present to reflect on whether the profession as a whole is doing enough to earn patients' trust and respect, Dr. Carrese said. Although trust in physicians fell during the pandemic, patients had more trust in their own personal physicians (84 percent) than the healthcare system as a whole (64 percent), according to a 2021 survey conducted by NORC at the University of Chicago. At the same time, most physicians (98 percent) said spending time with patients is an important part of trust building, but 77 percent of patients said they do not think their physicians spend enough time with them. If the loy view of medicine declines, there is also a risk "that we will not continue to attract the best and the brightest," Dr. Kaplan said. is trend is already playing out in some specialties. For example, fewer medical students are opting to specialize in primary care, a 2019 report from Kaiser Health News found. While internal medicine was seen as a prestigious field in the 1970s, higher-paying, high-tech specialties such as orthopedics or gastroenterology are now among the most competitive and prestigious specialties. "I'm not advocating for medicine to not be a sought aer or prestigious profession, but the reason people go into medicine should not be because they want to be in a prestigious profession," Dr. Kaplan said. "It needs to be about the work and the mission and the opportunity that we physicians have to create more health and a better environment for all of us." n Respect staff or seek care elsewhere: Mass General Brigham enacts patient code of conduct By Erica Carbajal S omerville, Mass.-based Mass General Brigham has instituted a patient code of conduct to protect staff from harrassment and discriminatory behavior, according to a Nov. 4 report from FOX affiliate WFXT. The policy makes clear that "words or actions that are disrespectful, racist, discriminatory, hostile or harrassing" will not be tolerated. The health system said examples of intolerable behavior include offensive comments about a person's race, accent, religion, gender, sexual orientation or other personal traits; refusing to see a clinician or other staff member based on personal traits; physical or verbal threats and assaults; sexual or vulgar words or actions; and disrupting another patient's care or experience. "If we believe you have violated the code … you will be given the chance to explain your point of view," Mass General Brigham's code of conduct webpage says. Some violations will result in patients being asked to make plans for future non-emergency care elsewhere, "though we expect this to be rare," the health system said. "Just as we have policies for our employees and clinicians to treat each other and every patient and visitor with courtesy and respect, this policy helps to define appropriate behaviors for patients, family members, visitors and research participants," Mass General Brigham said in a statement to WFXT. While other U.S. health systems have similar policies, Mass General Brigham is the first in the state to implement a patient code of conduct, Massachusetts Nurses Association President Katie Murphy, RN, told the news outlet. "We're seeing threats of violence. [Patient behavior] has certainly gotten worse since the pandemic," Ms. Murphy said. "People will be shown that there's really a policy and you cannot treat healthcare providers like that." n