Doctor's Choice: Is He Really Right?

It had four inches of diameter, the fibroid the gynecologist discovered in the womb of his patient. The harmless tumor was the explanation for the heavier haemorrhages under which the Munich mid-forties suffered. "Get the uterus removed," said the doctor. And immediately put his patient's business card to a private clinic in which he has his documentary beds. But the woman first went to another doctor. There she learned: fibroids can also be removed gently - with a small operation and without the loss of the uterus.

Who else can patients trust? How do you know if the doctor thinks of his diagnosis not only on his wallet, but also on her well-being? Anyone calling a normal specialist today is usually not asked first what he is missing, but "private or cash." In the German health care system, it seems that currently the question of costs is more important than the human being.

Doctor's Choice: How do you recognize a good doctor?

The patient needs to know what type of medicine he wants.

No wonder the relationship between doctors and patients has become a topic of study. A social science project of the "Future Health Policy Forum" from Passau shows a clear trend: "We are increasingly focusing on two-class medicine," says Project Officer Michael Schmöller. "We are seeing increasing numbers of a new type of doctor who defines himself as a for-profit healthcare provider."

Flyers provide information on a wide range of self-pay personal health benefits (IGeL) that promise smooth skin or bright white teeth. In the meeting room, a fragrance lamp spreads soothing lavender scent. And the receptionist behaves more like the receptionist in a luxury hotel. Unfavorable for health insurance patients, say the Passau scientists: Because they can charge less, in the future they will have to reckon increasingly with longer waiting times and get offered a poorer service in practice. Bad luck, but also for private patients: Because their cash registers perform many extra services, they occasionally have to undergo completely useless, perhaps even risky examinations and treatments - stress ECGs, even though the heart beats perfectly normal; Magnetic Resonance Imaging (MRI) because it tweaks in the back; Anti-aging checks that prove nothing.

So how can patients recognize a trusted doctor? What can you do to be treated optimally? "You just have to listen to their feelings," says social scientist Michael Schmöller. Explains the physician various options for treatment? Will he not be impatient with inquiries? Does he know recent studies? Or has he been treating with the same methods for 20 years? To experience this, doctors and patients need one thing above all else: time. And that's exactly what it seems to hapern.

Needless time costs the doctor, for example, visits from pharmaceutical representatives.

The average consultation period in German GP surgeries is on average only 7.6 minutes, of which the doctor speaks a good three minutes. By comparison, physicians in the UK have their patients at least 11.1 minutes, in the US even 19 minutes in the consulting room. However, a study by the University of Dusseldorf also showed that if discussions end after less than six minutes, the danger of mental disorders not being recognized, for example, is particularly high.

"Each representative usually takes five to ten minutes," says Professor Klaus Lieb, Director of the Department of Psychiatry and Psychotherapy, University of Mainz. He is on the board of the association Mezis e.V. - "I pay my own food". The members do not receive any pharmaceutical representatives and continue to train independently. Beneficial for the patients and for the community of solidarity.

Important when choosing a doctor: How long does the consultation take?

Because pharmaceutical representatives try by gifts and invitations to congresses, doctors to move to prescribe new drugs. "These preparations are usually not only considerably more expensive than precursors," says Klaus Lieb. "There is also less experience with it, which puts patients at greater risk, and studies show that doctors who do not accept pharmaceutical representatives are on the prescription of cheaper drugs, which saves an average of 20 percent on prescriptions." Mezis doctors therefore usually come with their drug budget. And have more time for their patients. But a good doctor needs something else: patience and the ability to listen. Strengths with which women often score points.

On average, they talk to patients in Germany for at least 1.1 minutes longer than their male counterparts. They seem to be much more attentive, caring, empathic."And they enrich the medicine by taking into account the sex differences that have been researched," says Dr. Astrid Bühren, President of the German Medical Association. Researcher Schmöller is also convinced: "Women take more time and see themselves more as an equal partner of patients."

So women are the better doctors? This can not be generalized - after all, there are also male doctors who listen patiently, and greedy doctors who try to convince patients of unnecessary inlays and investigations with dubious validity. To differentiate here is not so easy: "Anyone who wants to be optimally cared for in the future as a patient should know and get informed information about the doctor," says Michael Schmöller.

That too is important when it comes to finding the right person. The question "conventional medicine or naturopathy" alone is not enough. Thus, in a modern "service provider", only someone in good hands who is prepared to invest a lot for their health and who is open to both medical technology and the latest trends. If you are looking for quick, pragmatic help when you really need something, you will probably get along better with an experienced traditional family doctor. And someone who likes to decide for themselves what is good and right for their well-being, will have serious problems with a demi-god in white who decides over his head and does not tolerate the slightest doubt about it. Only when doctor and patient harmonize can trust grow.