The words "patient" and "doctor" shouldn’t be used in the plural

The words "patient" and "doctor" shouldn’t be used in the plural

Wed, 20/03/2019


Doctors and patients are often homogenized into two main categories: the caregivers and the people receiving treatment. But everyone has their own specificities, depending on their experience, their training, where they come from, etc.

In addition to what public policies propose, different parameters should be taken into account for Julie Henry, lecturer in philosophy at École normale supérieure de Lyon. Her research has been published for the Health Innovation forum that took place on March 13, at ENS de Lyon.

The word "Patients", but also the word "Doctors" shouldn’t be used in the plural anymore, to help us rethink health care and ethics. Not all patients are vulnerable, nor are they all fighters. Not all of them put their health at the top of their priorities or take an active role in their healthcare post-treatment, some also want to be cared for, others not. You don't change personality because you get sick. Humans are not just only an organic body that must be cared for, nor are they just a logical and astute mind.

From a medical point of view, we have to understand what determines the relationship between doctors. After all, it is not the same thing to be an oncologist and to treat cancers on a daily basis, or to be a pulmonologist and to have to occasionally treat lung cancer. The two doctors don’t have the same training, or work in the same environment, or have the same skills. All medical professions are very different, from one specialty to another, but also from one town to another. Doctors in a small town or in rural areas must also be considered differently from their urban counterparts: they may not be an expert on pathology, but they know the environment in which the patient evolves.

These factors influence the representations that doctors have of their colleagues. When health reorganization plans do not achieve the expected results, it is often assumed that it is the stakeholders themselves who haven’t put enough goodwill into the new measures. But if public policies want to encourage increased collaboration among caregivers, these different factors must also be taken into account. We need to think about how to create close links between the different medical professions because the success of this collaboration depends on it.

Giving consideration to caregivers in different areas

Public health policies usually start in inner city medical centers and then radiate out to the suburbs before reaching the rural areas. But we don’t think about doing things the other way around. We should link the work carried out at large specialized centers to the work in different areas, out of the cities, to bring them closer together.

In fact, we should also make the suburbs and rural areas more attractive to medical professionals and give more consideration to caregivers working directly in these areas. What can they bring to the patients and specialist doctors of the CHU? It is up to the big urban centers to ask that question.

Despite many efforts, politicians do not quite understand what a medical desert is, and what this implies for the patient in practical terms. The plan “my health 2022”, put forward by the French government, provides for coordination positions, to refocus care on the patient and a reorganization plan for healthcare. For a patient who is familiar with the health care system, this plan works. But for a patient who is not so familiar with the different healthcare options, it's not sufficient.

“The medical desert” puts things in a different light: if access to a general practitioner is not possible, how can we imagine having access to a specialist? This distances the patient geographically, but also mentally, from appropriate health care. Let's take telemedicine as another example. For a city dweller, looking up information online is part of everyday life. For a person who lives far away from a medical center,  getting information from a website or taking an appointment online is an abstract concept that is not an automatic reflex. You have to create a mental link, and no technological tool can do that - this is the issue of public health today.

Source: Il faut remettre au pluriel les mots "patients" et "médecins", La Tribune, March 11, 2019.