It would appear, Dr. Wander, that, in the main, you have reiterated and are very much in agreement with most all of the points which I had made.
I will, however, stand by my point that patient referrals are rarely a good basis for assurance of quality care. A patient who has had a successful surgery, even by a generally incompetent doctor will still praise that doctor to others, and those who have had surgery by a very competent doctor but who had the misfortune to have had an undesirable result (and even the best among us do have such results from time to time), will forever opine that the doctor was no good. But anyone who makes an important judgment after a solitary experience is prone to either understate or overstate the situation in terms of the individual, anecdotal experience which he/she had.
The only other means by which a patient has to judge his/her doctor is that doctor's personality, affability and friendliness, whether that is simply a practice management technique or not. Unfortunately, some of the most incompetent among us have highly developed social skills, which they then lean upon in lieu of knowledge and technique. The most incompetent podiatrist of whom I know could sell patients the Brooklyn bridge in the middle of the Sahara Desert. Sure, it is preferable to have a good personal relationship with one's doctor, but when push comes to shove, it is knowledge and skill and not his/her personality which makes or breaks the treatment.
Affibility is certainly a desirable plus, but a sharp instrument in the hands of a skilled bastard is preferable to one in the hands of a lovable incompetent any day. It is the RESULTS which is the basic need and desire and interest of the patient, not the glad hand.
What IS important is that the doctor be honest with the patient and keep that patient well advised as to what the diagnosis is, what the treatment is all about, the relative success/failure rates of the treatment IN HIS/HER HANDS, the anticipated consequences, such as pain and disability and the possible risks and side effects and their frequency of occurrence. |
