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Comment by Gatsky | Hacker News Reader

The president of Medicens sans frontieres, Rowan Gillies, gave a speech once. He had a drawing of a patient and the doctor inside a circle. His comment was 'Other people keep trying to climb into this circle. They can all fuck off.' Excuse his profanity, but I offer this response to you, who knows nothing about what I do, and understands nothing about quality healthcare.

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Of course if you ask a clincian if they should be regulated more, they will say no. The fewer stakeholders involved in the relationship between patient and doctor, the more power the doctor has. The truth is there should be others involved, at the very least the government health agencies.

Actually doctors would be universally happy to get more help and support to deliver better healthcare. That you don't talk about that is quite telling, or is that what you mean by 'regulation'?

Casting the patient doctor relationship in terms of power dynamics is a bogus sociological construct divorced from reality. The true division of power is between those who fund healthcare and those who receive it, I would start there if you think things need to be improved.

Yes - regulation is not the same as better support for the healthcare system and I am surprised you do not get that distinction. Regulation is about putting rules into place to prevent fraud, malpractice and anything where the clinician may abuse the system to the detriment of patients or other healthcare professionals around them. In addition to regulation, the government should also support the healthcare system through better funding and (patient and clinical) education. It can be true that both more regulation and better support are needed.

To say there is no power dynamic between patient and doctor is wildly ignorant. There obviously is one, even if the patient is not paying the doctor directly for their services. Not sure when (if?) you went to medical school, but this is taught to all medical graduates. The field of medical ethics exists for a reason.

What if the patient wants other people in the circle? (I do, when I'm a patient. I've never really trusted doctors I've had due to my perception of competing motivations, and they've given me reason for that distrust more than once).

Sorry to hear you have suffered poor quality interactions with doctors. Being honest, if there is no trust in the relationship between patient and doctor, then nothing else matters much as the experience will be poor on both sides.

Patient can of course bring whoever they want into the circle. The problem is the intrusions that neither healthcare provider nor patient want.

From the point of view of the experienced patient it's not a single circle, it's a Venn diagram with the patient at the center of multiple overlapping circles.

But sure, uninvited third parties shouldn't butt their head in often, except for the occasional regulator.

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