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World Health Forum. 1995;16(3):221-7; discussion 227-47.

What do people expect from their doctors?


Surprisingly few people seem to worry about the technical competence of doctors. What they worry about is their doctor's ability to understand the patient as a person and provide the right guidance. Financial, legal or managerial techniques seem powerless to ensure that this demand is met. The solution should be sought within the medical profession itself.


This consideration of what people expect from physicians asserts that people want a physician who listens, sorts out problems, and is available to them consistently, not one who merely applies medical science. This points to the centrality of the consultative aspect of the physician-patient relationship. In some health care systems, the general practitioner (GP) is the gatekeeper for more specialized (and more costly) care. According to the World Health Organization, the purposes of medical services are to achieve equity; to reduce the possibility of premature death, disability, and disease; and to encourage self-actualization. GPs can ensure equity by judging urgency and negotiating honestly with patients about the need for medical intervention. Once patients have been referred to a specialist, GPs can become patient advocates. Trusted GPs (as opposed to a team of doctors) can also help patients make strategic life decisions. In addition, GPs have an important role to play in defining the boundaries of health and illness. Thus, GPs influence whether people seek medical care appropriately, tolerate debilitating conditions, or engage in behavior that can be characterized as "health neurosis." Efforts to ensure that physicians deliver quality care have included encouraging competition for consumer/patients, issuing performance contracts, and encouraging litigation. The best way to ensure quality, however, is through the self-regulation offered by peer reviews of total patient management.

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