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Show More maneuvers. The door is open. Now the uninvolved knee is examined: abduction, adduction, flexion, extension, rotation. She gives up. The door is open. Now a discussion of surgical technique. Now review the knee examination. We file out through the open door. She pulls the sheet up around her waist. She is irrelevant (Meyd, 1982). Bill Moyers, in a National Public Radio interview, suggested the adaptation of an Eastern medical philosophy when considering the patient. In the West, the human body is often regarded as a machine. When something goes wrong with the machine, the doctor acts as mechanic and repairs the problem or replaces the parts. One Eastern idea is to view the human body as a garden. A garden has many interrelated elements, and it must be nurtured and cared for. The physician becomes a gardener who helps the garden to grow and thrive. "By simply changing the metaphor, we change the attitude toward the patient" (Moyers, 1993). The role of any healthcare worker, including anyone who works in a hospital, should conform with the basic physician's role: "to cure sometimes, relieve often, but comfort always" (Leebov, 1988). Such comfort originates in the human touch, and too often that touch is missing in modern healthcare. While the human touch - the healing touch - is a significant element of direct medical care, it does not come from the physician or nurse alone. Hospital telephone operators, office receptionists, orderlies, housekeepers, nutritional care workers, radiology technicians, administrators, and the whole gamut of hospital workers all contribute to the healing process through every interaction they have with patients. In any interaction between hospital staff members and patients, the hospital employee possesses greater power than the patient. "As is common in such instances of vast power differential, the patient is often treated as an object" (Friedman & DiMatteo, 1982). The depersonalization and objectification of patients are among the most significant interpersonal problems in healthcare, and they are major contributing factors to the dislike many people have for hospitals. The routinization of procedures substitutes formulae for personalized care. Patients entrust their bodies to the care of strangers in an unfamiliar environment. They are then expected to be "cooperative, dependent, and helpful without demanding too much attention...The patient becomes part of the staffs schedule, appearing on a number of different lists as the recipient of a number of different services" (Taylor, 1982). The multiple levels of authority leave a patient with no loci of authority to turn to with questions or problems. The large numbers of staff involved in day-today treatment result in fragmented medical care. All of which contribute to a patient's confusion and virtual anonymity. "Patients are often referred to (and thought of) in terms of their symptoms, disease, or condition" (Taylor, 1982). Upon admission to a hospital, a human being becomes simply a heart, a kidney, an appendix, or a knee. Withholding information regarding their care keeps patients passive and dependent. It serves the interests of the staff more than the interests of the patient; staff may withhold information simply because it might take too much time to communicate the information effectively. They might also withhold information because it might alarm the patient or because the patient might misinterpret the information (Taylor, 1982). If patients are to be participants in the healing process, it is important for them to be well-informed. While there are possible limitations to this informed participant role, healthcare organizations must still address the changing role of the patient. Redefining the patient role is a major step toward Utah's Health: An Annual Review 1993 85 |
