Seventh question: are we managing the relationship with doctors well?

Relations we build with doctors are also important. They are our interlocutors of that scientific, professional and organized medicine that is offering us cancer therapies. It can easily happen that we need to manage problems that may emerge in our relationship with doctors. They might not appreciate our effort to retain independence for a number of reasons, like the fear of losing control over us and the treatment we are following or the difficulty of committing to take part in discussions that go beyond what they are used to. They might feel uncomfortable with the idea that we carry out some research on our own and explore potential therapeutic alternatives. The fact that we do these things may be perceived as a threat to their professional standing or can make them feel uncomfortable simply because they have to make an effort to study and think more than it is usually required of them.

 

The traditional professional culture of doctors goes against the idea of that doctor-patient relation needed to carry out an intelligent treatment of cancer. Traditionally, there is a tendency to consider the professional expertise of a doctor like a personal possession, something well defined that a given doctor, thanks to his or her studies and experience, has (in his head, masters) and uses to answer requests.

This way of understanding medical expertise does no longer hold. It cannot work for a variety of reasons like the rapid developments of medicine, the development of communications and of new technologies, the growing complexity of the health system and the fact that professionals are more and more often asked to be accountable for their work publicly. This illuminating story can help us to understand this - to read it click on the button at the bottom of the page.

Among the reasons that make this old conception of professional expertise inadequate there is the increasing need to change the way doctors relate to patients. Nowadays, the person affected by a disease has access to information and feels the need to be the protagonist of his or her care. At the same time, this person needs guidance that will allow him or her to not get lost in the process a guidance that leaves room for the autonomy of the person concerned. In order to make this happen, there is a need of doctors with a more fluid, dynamic and open-minded vision of their expertise who are no longer anchored to the idea that competence is a personal possession.

It is often hard to build a relation based on an open dialogue with doctors when the burnout syndrome prevents them from doing so. This psychological condition affects people who work in the helping professions, in particular oncologists. It seems that it derives from the experience of having worked hard with disappointing results. People affected by this form of mental disorder have exhausted their resources and feel that they are no longer able to relate to others and help them.

Studies suggest that many oncologists suffer from burnout syndrome. However, both they and people around them often do not realize this. The point is that when they are ‘burnt out’, since they still have to work as oncologists, they react in various ways: they become cynical or bureaucrats who are too worried about following the protocol or become insecure, anxious and despotic. Thus, their mental disorder, caused by the difficulties posed by their profession, is interpreted as a trait of their personality. In any case, doctors affected by burnout syndrome hardly ever accept to take part in an open discussion with a patient or, if they do, they tend to do it only to all appearances and not in reality by reciting a script. But we need real interlocutors willing to really discuss things with us.

In order to be able to manage our mind and the relationship with our loved ones and doctors we must, somehow, become a little bit like psychologists or, at least, learn something about the psychology of cancer and have a grasp of those psycho-social dynamics that come with this disease.