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Trifle verities always appear to be the truest, so is a well-known saying ‘Health is the most precious treasure’. It is not surprising then that health and health care issues have been evoking so much discussion in the society. Nowadays there is a great problem which the community is facing and it is the level of trust a patient can grant a doctor. The health care system now allows patients to somehow influence the overall situation and rate the doctors they have applied to with scores – either good or bad. The issue here is how a patient can definitely know (not being an MD) if the doctor’s judgment is absolutely right and the cure, they have prescribed, is the most effective. Moreover, sometimes the doctor’s and patient’s judgments can be absolutely polar when the first has years of study behind the back and the second has years of watching ER, House MD, Scrubs and the like. Dissatisfaction with the measures undertaken by the doctor can lead to patient’s frustration and unhappiness and a lower grade for the doctor. This problem has been mention among ‘Health care's top 2012 issues’ published by amednews.com (Dolan, 2011). So, where is the golden mean here?

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This problem has become a focus of the article Patient satisfaction: When a doctor’s judgment risks a poor rating by Kevin B. O'Reilly (2012) published on amednews.com. The problem raised by the author is very actual now because, on the one hand, patients who are always very sensitive, require special attention and can feel offended if not ‘taken care of properly” (in their own interpretation of the word ‘properly’ which usually means ‘treated from al their pains and illnesses just immediately’). And, on the other hand, doctors care for their reputation and do not want to be rated bad because of the deeds which a patients could consider inappropriate. And, of course, doctors in any case do not want their patients be unhappy.

A curious but still alarming situation is described in the article. A patient came to Dr. Sullivan and asked to write a note to excuse her absence from work due to a small pimple on her nose. When the doctor asked how that almostinvisible acne could influence her ability to work, the patient answered that she had been crying about it the whole night. The doctor refused to issue such an excuse note and suspects that patient to be among those dissatisfied who have given him bad score.

The situation here has got several important aspects. The patient’s self-esteem must have suffered due to the pimple, and the doctor’s refusal added some frustration to the already instable patient’s mood; the doctor’s reputation has suffered due to a patient’s sensitiveness and, to some extent, incompetence in the specifics of sick leaves issuing. Also the reputation of the clinic can suffer, because it is also assessed by the rating of its doctors. However, the solution of the problem seems to be rather simple. First of all, new criteria for evaluation of doctors by the patients should be developed, which could provide the most fair and clear assessment of the doctor’s actions for a patient. Second, special leaflets clearly and transparently describing doctor’s and patient’s duties and rights should be issued and spread in all the clinics and other medical organizations. Third, a special propaganda campaign should be organized aiming at explaining the specifics of the doctors’ job and the importance of the most accurate and fair patients’ rating. Such measures can prevent such diminishing o? doctor’s rating by a not very competent patient in future, and also can give patients all the necessary information about the specifics of medical job and doctor’s duties they need to know.

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In general, situations when patients intrude into doctor’s work or mistake it are very frequent. Certainly, every person has the right to be aware of their medical state, of the prescriptions and of the treatment plan and this right is not alienable. However, sometimes patients tend to be rather intrusive and manipulative, trying to persuade the doctor to give  them the treatment which the doctor themselves consider inappropriate. Such cases are mentioned in the article under consideration: Dr. Zgierska described situations which are rather frequent in her doctoral practice:

“If I feel the patient is not an appropriate candidate for opioids, I should say no,” she says. “But in the back of my mind, the question can arise, ‘What will the patient do with that?’ Especially since the No. 1 question on our patient-satisfaction survey is, ‘Are you happy with the way the physician treated your pain?’ ” (O’Reilly, 2012).

The question mention in the quote is really tricky. Is it possible to find a proper answer to it? And what factors should be taken into account to measure it? For instance, the doctor can give the patient a bitter medicine which will taste disgustingly but be 100% effective. Can the patient be fully happy with the way the physician treated their pain? Absolutely not. So, I think, that patients should be fully informed about the medicines they are prescribed and al their properties including the effect, the dose, side effects and even taste, for them to be fully aware of what they are taking. Medical commercials (even including vitamins) should be absolutely banned from the mass media so that a patient could not demand the doctor to prescribe this or that as-seen-on-TV medicine just because the patient liked the advert.

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Besides people should be made aware not only of their rights in relation to medical care but also the sequences which can occur when the patient insists on their version of treatment. People who are in need of medical help ought to know that doctors and other medical stuff will take into account their wishes although the whole process will be organized in accordance with medical guidelines and protocols. The society has to choose its attitude to medical care on the whole – whether doctors are viewed as life rescuers or simply as medical service staff. Solution of the problem of trust can dot all the i's and cross all the t's in the question of medical service ethics.

Personally I recommend special type of contract between the doctor and the patient about that the latter must take all the responsibility for the results which can emerge in case of the patient’s intrusion into the treatment process and performing actions which are not prescribes in the medical guidelines. This will bring some order into medical care system and let people avoid many court trials connected with medical issues.

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