The Doctor and Patient
The relationship that exists between the doctor and patient is an essential part of the therapeutic process in all specialities.
When I trained to be a GP in the 1990’s I was encouraged to care for my patients, but ‘patient-centred care’ was not a term used by my experienced and wise trainers. It is now the focus of GP Training. It’s easy to assume that everyone, including the patient, knows what this term means, but I’m not sure it’s that easy. So here are some resources to provoke thought and discussion.
In 1890 Henry Tate commissioned artist, Luke Fildes to paint a picture of his choosing. Fildes painted this picture in the relatively new genre of art ‘social realism’. It is said to have been inspired by the compassionate care Dr Murray, the family doctor gave to Fildes’ son Phillip who died from typhoid fever on Christmas morning in 1877. Fildes wanted “to put on record the status of the doctor in our time”.
Take a look at the whole picture and describe what you see.
What does the picture tell you about the family?
Most importantly what is happening in the space between the doctor and the child?
This painting by Picasso was inspired by the death of his sister, Conchita. It’s an allegorical picture, the doctor taking the pulse represents science and the nun offering the sick patient soup represents charity.
Consider the picture from the perspective of the doctor and the patient.
Examine this picture.
Questions you might ask are;
What is happening in the picture?
Who are the people in the picture?
How are they positioned in the picture?
Why has Delacroix put a skeleton in the picture?
What role are the doctors playing in this ‘consultation and what about the patient?
What thoughts do you have about this price of text from Aphorisms by Hippocrates c.460-357 BC?
Life is short, science is long; opportunity is elusive, experience is dangerous, judgement is difficult. It is not enough for the physician to do what is necessary, but the patient and the attendants must do their part as well, and the circumstances must be favourable.
The poem A note of warning to patients when all else fails by Glenn Colquhoun puts the patient back in the centre of the picture.
Think about your last consultation:
- How would you describe the role you played?
- What role did the patient play?
Now think about this excerpt from As you like it by Shakespeare:
All the world’s a stage,
And all the men and women merely players;
They have their exits and their entrances;
And one man in his time plays many parts,
Can you think of your last consultation in theatrical terms, was it a duet, and duel, a soliloquy, or a carefully scripted and rehearsed play?
In essence, the consultation is very simple, the doctor enables the patient to share their agenda, the doctor then discusses his agenda and a decision about what happens next is agreed upon. This all works better when there is a relationship between the doctor and the patient.
In what ways do you think the doctor-patient relationship has evolved over the last century?
Is the doctor-patient relationship different in other cultures and countries?
Please let me know if you have any art resources to help explore these two questions
Surgeons have scalpels, ophthalmologists use slit lamps, and GPs use the art of consultation. Most doctors learn to consult while working alongside their GP Trainer. This learning can be enhanced by reading a consultation skills book- take a look at the resources and the feedback from our GP Trainees.
Page created 2018 updated 2023