Once upon a time, medicine and health care were solely focused on the patient. What does the patient need? How can we help them and make their lives better? Physicians had more time to talk with their patients and truly get to know and understand them. Physicians and health care teams were a source of comfort and healing. Our health care system is forgetting them.

The relationship between a physician and patient forms the backbone upon which diagnosis and treatment are based. In my experience, surgery is but a small part of helping a patient navigate the journey of breast cancer.  My patients, their families and I become a part of each other’s lives, and we both are forever changed.

We become physicians for patients. Patients rely on us. We need to be able to diagnose and treat them when they are sick, heal their broken bones, and educate them on maintaining and building a healthy lifestyle. Caring for patients IS the reason we practice medicine. Building a lifetime relationship with our patients is the goal.

The patient-physician relationship has been changing over the years, and it seems that we are drifting further apart. Patient data is collected and reviewed, diagnoses and plans are made, compliance is developed, and healing can be achieved. However, there is an extra, unnecessary chair in the exam room.  As insurance coverage and compliance for medical care become more administrative-based and complex, the need for a strong physician-patient bond is fading. Medical decisions are no longer being made by just the physician and the patient’s health care team. Insurance companies, government entities, and employers are inserting themselves into the sacred relationship of the physician and patient.

The third chair is another barrier to care. Physicians are trying to work through endless paperwork, denials from insurance companies, and so much more. Patients are having many of the same struggles. They get denied payment from their insurer, struggle with insurance price fixing (surprise billing), and as the need for physicians grows, the harder it is to get needed appointments.

We need to reinstate the patient and physician relationship as a key driver for health care system change. Perhaps someday, Dr. Google will be able to provide a technical answer to a technical question, but it will never truly care for you, or walk alongside you in your journey.  Patients come to us in their most vulnerable moments, and we need to be able to treat them without the influence of the third chair.

Clifford L. Deal III, MD, FACS
The Medical Society of Virginia President