Book review: The Good Doctor – What Patients Want by Ron Paterson

cv_the_good_doctorThis book is in bookstores now.

The back cover of this book begins with three thought provoking questions:

  • ‘What makes a good doctor?
  • Why are there bad doctors out there still practising?
  • And how can we protect patients, increase trust and improve medical care?’

Important, critical questions that should be of interest to health professionals, patients, and in fact, everyone. As a health professional, I was immediately intrigued. Every health professional knows of someone they would NOT recommend to the family, or worse, someone they would advise their family to avoid at all costs.

Ron Paterson (Professor of Health Law and Policy at The University of Auckland) knows better than most what makes a bad doctor; he was after all the New Zealand government’s Health and Disability Commissioner for the first decade of this millennium. He has dealt with many complaints, some substantiated, against health professionals. Paterson draws upon this experience in a balanced and rational way; he interweaves international research and cites numerous New Zealand and international examples and in doing so illustrates the complex situation that health professionals find themselves practicing in.

There is little doubt that as the title suggests patients seek (and indeed deserve to have) a good doctor. It is this subjective criterion of good that is challenging and not universally defined  There are many definitions of perceived “good” from a patient perspective: good is a doctor who listens to me; good is a doctor who tells me what I should do; good is a doctor who allows me to make an informed choice; good is a doctor who makes no mistakes.

What is clear is that many of the high profile cases of medical incompetence are in fact criminal acts, and no credentialing nor registration process will prevent those. So what remains to be devised is a system that protects patients and is supportive and not overly onerous on health professionals. Paterson the HDC adopted the motto “Learning , not lynching, Resolution, not retribution”. A rather balanced view don’t you think? And this should be thoroughly achievable? Not easily.

Ron Paterson weaves his way through this complex situation where individual patient management is sometimes not obvious; that a measure of creativity is required; and some mistakes are inevitable. He presents good arguments on all sides.

For readers who are not health professionals, this book will cast some light on a professional that they interact with as patients but possibly know little about other than what they see on American-based hospital dramas. He also delves into the area of web-based medical advice and cautions that whilst it is probably okay to take advise about a hotel from, the internet may not be the best place to gain individualised medical advice where the inherent risk is potentially much higher. But many health professionals face-off against Doctor Wiki each day, adding a new burdon to their already challenging job.

For readers who are health professionals, much of this information will not be new; but the collation of data and encouragement to think beyond today will be refreshing. It’s a relatively easy and thought-provoking read, but not one to consume in a weekend. In fact, I think the longer the book is allowed to percolate through your conscious the better.

Reviewed by Gillian Torckler

The Good Doctor – What Patients Want
By Ron Paterson
Published by Auckland University Press
ISBN 9781869405922

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