What was once a close patient-physician relationship has given way to a series of rules
«The family doctor of the 1950s ceased to exist for two reasons,» Professor Eftychios Voridis told Kathimerini. «One is that the doctor’s task is no longer to deal with the patient but with the disease. Medicine is practiced according to specific rules and so doctors have to complete certain procedures, such as laboratory tests – which are often unnecessary – in order to make a diagnosis and do the right thing by the patient.» As Voridis noted, apart from awareness of the patient’s history, family doctors used to know family secrets and so could help in many ways, since they understood their patients’ emotional makeup. «It’s hard for doctors nowadays to operate at that level,» said Voridis, «and that is why, strange though it may seem, I have the impression that if we judge effectiveness by how well the patient feels, then doctors in the past were more effective. «The second reason, in my view, why the family doctor disappeared was the nationalization of the health system. The old family doctor had a sort of economic contract with the patient, where the family paid the doctor – not much, often in kind, perhaps a basket of eggs. It was a contract where both sides said, ‘I’ll help you to live and you help me.’ «That created a significant bond and, typically, although the old family doctors were not those who had the most training, they had the fewest complaints made against them for poor medical practice. «Doctors today are not paid by the patient but by the state, and that gives the user of health services the impression that the doctor serves the employer and not the patient. And that, to a large extent, has abolished the trust between doctor and patient. You could say that the old neighborhood or village doctor was not rich but useful. Today’s doctor is more capable and cultivated, but on the other hand he is remote from the patient.» An important part in this is played by the doctor’s career which, as Voridis noted, is not based on clinical skills. «When a doctor applies for a post,» he said, «what is taken into consideration by those who decide is not their dedication to patients but which university they did their postgraduate studies at, how many congresses they have participated in, how many papers they have written and how many studies they have worked on. «So the career of a doctor does not differ greatly from that of a literature teacher or mathematician. But this keeps them at a distance from their patients, since they cannot find the time to spend on them.»
