The doctor-patient relationship: opportunity to heal: Edward Garbacz, MD explores the joys of receiving (and practicing) medicine with heart. (Commentary).

The "doctor-patient" relationship has traditionally been treated by societies as a sacred (and legally- and morally-bound) relationship for millennia. This is so because the sharing of information about ourselves as patients to our physicians is a very vulnerable, intimate process that frequently involves (and, indeed, may require) the revealing of our innermost selves in the course of seeking health care. This "revealing" is at the core of the healing process and is not exclusive to medical physicians; it includes practitioners and healers of all types. Furthermore, although we may be unaware of it at times, this "revealing" illustrates not only our desire to be free from our illnesses to live fuller and longer life, but also it is a vehicle for the continued development of our serf-awareness and understanding so vital to the development of self and its relationship to others. In this sense, this relationship is as important as all our others-marriage, familial, friendships, professional, etc. It is through our illnesses (and the contrast between the states of health and illness) that we come to understand who we and our fellow humans are and discover how to renew our vital relationship with ourselves and to Our environment.

In this article, I seek to explore this hallowed relationship in light of how both practitioner and patient may reawaken, explore, and deepen their understanding of it and employ it to its true maximum potential for healing and the love of self and other. No less important is the healing of the relationship between medical physicians specifically and patients at a time in our society when many patients and physicians alike feel a rift in that relationship in the wake of the many changes that have occurred in our health care system and our society and our world in the past fifteen years.

At their core, our illnesses clearly may be seen as reflections of an imbalance in our relationships to ourselves and our total environment-physical, community, familial, societal, political, economic, etc. These are complex relationships to be sure, regardless of whether they involve our exposure to a weather change or infectious agent ("bug") or reflect our succumbing to the pressures of work, relationship, or other life stress. Very often, we are unaware of this process of imbalance (in a large sense why we got sick to begin with). The processes that lead to our falling ill may indeed be very complex and require the intense analysis by both physician and patient to reach their resolution. Tune is a vital element here. Some problems require only 10 or 20 minutes to evaluate and treat (a simple cold or "flu"). Others may require more time to explore (such as if that cold does not resolve). We take time for the things we value. Health care is no exception. The time pressure of current medical practice is a critical factor in the quality of care today. Many patients have told me they do not feel "heard" or listened to by doctors and feel "hurried" at visits. Doctors face great pressures in our changed health care system but must struggle to maintain proper communication so vital to healing.

Another vital aspect of this relationship is the growth of complementary, alternative, and integrative healing arts over the past ten years. At the core of this growth is the welcomed return to self-determination in health care, the critical aspect of "self-healing," the mutual decision-making between practitioner and patient in determining treatment, the taking of responsibility for one's own health and the re-exploration of the multitudes of diverse healing methods with which God endowed us. Alternative medicine gives us the great opportunity to realize that none of us, physicians included, have all the answers and that we are seekers of a more complete knowledge and wisdom, which in part is the result of collaboration.

These new opportunities and choices challenge doctor and patient alike to change our views and re-explore ourselves and our health. Very often, it is the patient who must be patient with the doctor unfamiliar with these methods. Doctors, for their part, must be open to their patient's preferences and knowledge, taking them into serious consideration, exploring them with the patient and encourage. mutual learning and decision making. This can be a huge leap for the doctor who is very used to taking charge of the medical evaluation based on his training in a specific field of learning largely obscure to the patient. It may involve courage on the part of the doctor to suspend their medical knowledge and belief systems, at least temporarily, to allow new information to arise and be employed. It will involve courage on the part of the patient to be true to his or her convictions and beliefs and patiently follow through with the doctor. Of course, critical here is the willingness of doctors to listen, be curious and learn. Patients teach their physicians too. Remember, it is a relationship!

Regardless of the actual treatment determined to be required, so vital itself to relief or cure, it is the relationship of physician to patient that is at the core of this process. Its tools, which go beyond the choice and use of antibiotic, herb, acupuncture needle, x-ray or procedure, include thoughtful two-way communication, careful listening(especially on the part of the doctor) and the qualities of empathy, patience, flexibility, curiosity, humility, and willingness. To my mind, these are the expressions and tools of love itself, the ultimate healer.

Dr. Edward Garbacz, MD is based in Atlanta, Georgia. He can be reached at 404-848-0033.