Medicine as a trade

Abstract

The doctor-patient relationship is usually seen and accepted as a giving-taking association, in which the doctor is a giver and the patient is a taker. The paper challenges such a one-way relationship, and stresses the patient as a giver and the doctor as a receiver. The patient is described as a source for the emotional development of the doctor, and as a source of knowledge. He is also a source for what could be called ‘life experience’. By serving as a source for these three elements, the patient is also seen as a source for reward. There is a danger of under-utilisation of this reward by the doctor, when (1) he is engaged only in giving, (2) he wilfully obstructs the channel of information, and (3) he feels ‘saturation’ called by the doctor ‘experience’. This under-utilisation will ultimately lead to ‘medical parasitism’. This parasitism is seldom recognised by the patient, because the arrest of development of a doctor is usually hardly noticed, and this will lead to neglect of the patient, so that the ‘trade’ between doctor and patient becomes unfair, as the long-term investment which the patient has placed in the doctor, does not pay off any longer.