Rule No. 6: Remember: it's the patient's life, so you don't get to be in charge of it.

There's a line in Medicine that goes:
“What are the words every surgeon loves to hear from his patient?”
“Doctor, you just go ahead and do whatever you feel is right.”

Many doctors act as if patients turn their lives over to them to receive medical care. There was a real-life fiasco where a transplant surgeon got angry because he believed one of his patients was acting insolently towards him. As punishment, the doctor had the patient's name removed from the transplant recipient list. He told the family that the situation would not change until “a proper, heartfelt formal apology from the patient himself.”

Of course, such an abuse of control over a patient is unforgivable. The situation was reported to the authorities and the surgeon removed from the patient's care. He was formally reprimanded and denied any further say about what patients were scheduled to receive transplants. But it shows how some doctors' perceive patients to be passive objects, pawns under their command.

Patients have to be permitted to form a partnership with the doctor during their illness and recovery periods. The person who can help initiate that kind of relationship is the doctor. Each patient should remain the captain of his or her own ship. The physician is the navigator, making recommendations in course changes. The captain decides if they should be carried out.

I think that there has been a “sea change” in the public's attitude over the course of the last generation. Most people no longer simply trust doctors to take care of them a priori. Patients now take a more active, even challenging role in asking about the care they will receive. Patients rightfully see themselves as consumers, making a choice to see one practitioner over another. That said, many patients are still quite trusting and doctors must see one of their roles to become “coaches,” encouraging patients to tackle and understand the issues. Patients need to gain insight into the decision-making process, and, finally, to give or withhold consent. A good doctor builds each patient into a partner.