Where has the doctor-patient relationship gone?

“We used to treat patients. Now, we treat computers.”  Such is some of the frustration facing the 21st century doctor today.  In 2014, implementation of Electronic Health Records was mandated across the board in healthcare facilities in the United States.  This was done with the goodwilled hope that quality and efficiency would improve. Legible and easily transferable records would ultimately help the patient and decrease costs. Unfortunately, these systems have increased costs everywhere. Doctors are now less efficient because of tedious interfaces and the necessity of documenting unnecessary information.

One thing that has improved: monitoring… Now CMS can monitor doctors’ performance, and on the basis of what they’re [not] doing or documenting [in]correctly, decide their compensation.  It takes coders on both sides to determine the right codes to describe what the doctor did in order to bill correctly.  Entire degrees have been created just to become a medical coder.  What happened to the good ol’ days of seeing your doctor and just paying him what you could afford for your visit? Perhaps you could have bartered a goat or a chicken with your doctor.  Honestly, I can’t even tell you exactly what it costs to come see the doctor.  At our hospital, we have a 24 hour nurse (probably more than one) that is there just to determine whether your admission is “observation” status or “full admission” status.  Their daily job is to review the status of a patient’s admission because the hospital may be partially paid or forfeit payment if it is listed incorrectly. Have we really come so far that our job as healthcare workers is to make sure that we collect enough costs and document thoroughly so that we can keep our jobs?  I’m not against collecting money for services but it seems like we’ve lost the heart of what medicine is: The doctor-patient relationship.

Obstacles, barriers, curtains, walls.  These are what we have set between our doctors and the patient.  We have so many middlemen in the temple of healing now.  What occurred to me this week is that men are great at setting up barriers.  Our new emergency department (about 5 years old now) went to completely private rooms. There are 2 doors to enter the ED waiting area, 1 door to get to the back area of the ED, 1 door to get into the patient room, 1 door to get into the inner core of the ED pod, and 1 door still that can separate the doctor “fishbowl” from the inner core.  6 doors separate the doctor from the patient outside the hospital.  The suffering patient can be physically separated from the healer.  It is easy to see how, to the doctor, the patient could become just a name on a list in the computer, sitting in a room down the hall.  Even while in the room, the computer’s information may dominate the words coming out of the patient’s mouth or sound of their lungs in the stethoscope.  Is not being a doctor more than processing the data in a computer?  Why are politicians, bureaucrats, administrators, coders, and everybody else telling the doctor and the patient what their relationship should be? Yes, clinical decision aids are helpful in computers. Yes, legible data that is easily transmittable is good.  But have we forgotten what was basic to the healer-healed relationship?

I think the same is true in our spiritual lives.  We have forgotten the Doctor-patient relationship.  We have set up barriers to our worship and praise.  We have set up barriers in our relationship with God.  We do not want to be naked before our Creator.  We put doors between God and our transgressions.  We put gowns over our iniquities.  We put traditions and religiousness in place of intimacy.  But isn’t orthodoxy a good thing? The priests, pastors and congregation can then monitor our holiness!?… Is this the kind of relationship our Creator wants?

At first, it was from a distance. It was for our own good. The temple of Israel had regulations. God’s holiness was separated from us because He could not identify with our sinfulness.  Sin was utterly sinful and God completely Holy. To approach Him, certain steps had to be taken.  The entire book of Leviticus is filled with the regulations for worship in the temple.  Wash here, purify there, separate here, slay there, pour blood here, sanctify there.  Most importantly, separate the holy from that which is stained.  Keep them apart! In fact, “holy” means “set apart” or “to be sanctified.” How could He Who was Holiness identify with a fallen creation?  How could He possibly have a relationship with us?…It is because HE TORE DOWN THE BARRIER!

In Christ, God tore the curtain between man and Himself! (Mark 15:38, Luke 23:45, Matthew 27:51) God came in the flesh and suffered with us! He had compassion on us. Compassion is made of two words. “com-” or “con-” or “co-” prefixes meaning “together/with” and “pathos” meaning suffering.  “Path-ology” is the department we send diseased tissue.  It is “the study of suffering.”  It is He Who identified with our suffering. He suffered WITH us. He knew what the pain felt like. He was tempted in the same ways.  As Hebrews states, “For we do not have a high priest incapable of sympathizing with our weaknesses, but one who has been tempted in every way just as we are, yet without sin. Therefore let us confidently approach the throne of grace to receive mercy and find grace whenever we need help.” (Heb 4:15-16) Jesus was offered as the perfect offering to God so that we could have relationship with Him!  (Heb 9:11-25) This is the meaning of the communion.  It is the Thanksgiving offering. It is the Passover.  It is togetherness with Him.

Why do we set up these barriers? Why do we make excuses? Why do we not just turn to Him in our time of need? Why do we make everything a complicated procedure? Faith and trust is what He is looking for.  As Habakkuk says, “My righteous one will live by faith.” (Hab 2:4) And to David He said, “if My people who are called by My name will humble themselves, and pray and seek My face, and turn from their wicked ways, then I will hear from heaven, and will forgive their sin and heal their land.” (2 Chr 7:14) In Hebrews it says, “But without faith it is impossible to please Him, for he who comes to God must believe that He is, and that He is a rewarder of those who diligently seek Him.” (Heb 10:6) And to Micah He says, “He has showed you, O man, what is good. And what does the LORD require of you? To act justly and to love mercy and to walk humbly with your God.” (Mic 6:8) Should we not walk closer with Him?

John explains our relationship with Him well. “Now this is the gospel message we have heard from Him and announce to you: God is light, and in Him there is no darkness at all. If we say we have fellowship with Him and yet keep on walking in the darkness, we are lying and not practicing the truth. But if we walk in the light as He Himself is in the light, we have fellowship with one another and the blood of Jesus His Son cleanses us from all sin. If we say we do not bear the guilt of sin, we are deceiving ourselves and the truth is not in us. But if we confess our sins, He is faithful and righteous, forgiving us our sins and cleansing us from all unrighteousness. If we say we have not sinned, we make Him a liar and His word is not in us. (My little children, I am writing these things to you so that you may not sin.) But if anyone does sin, we have an Advocate with the Father, Jesus Christ the righteous One, and He Himself is the atoning sacrifice for our sins, and not only for our sins but also for the whole world.” (1 John 1:5-2:2)

Why do we continually set up barriers between the doctor and the patient? Why do we set up barriers between the Lord thy Surgeon and ourselves? A doctor must take a history and do a physical examination.  It requires talking with and touching the patient.  As doctors, we use light to see where the problem is.  It is hard to see exactly what the disease is without being in the room.  I cannot tell you if you need stitches if you don’t show me your laceration. So why is it we do not want to come into His light to show Him where our problem is? Our sin is painful. We are ashamed of it. It is the part of us that is ugly and deformed.  But the Surgeon has the healing we need if this sin is exposed to Him. He provides the sin covering in the blood of Christ  He provides the healing in the body of Christ.

Computers and technology are not bad. Orthodoxy is not bad.  The temple was not bad.  The temple was complicated.  So, let us (as doctors) get back to listening to the patient and examining them and identifying the problem. Let us stop treating computers and and go back treating to the patient. As patients, let us seek a doctor that listens to our problem and examines our iniquities. As patients, let us seek the Surgeon in prayer and seek His Word.  Let us seek the intimacy that He wants.  Let us go by boldly to the throne of grace. (Heb 4:16) Let us restore the Doctor-patient relationship by communion with Him.  It was God Himself Who established Doctor-patient relationship when He tore the veil on Calvary. (Mat 27:51)  It is God who is our Healer. He is the Lord thy Surgeon.

 

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