The Service of Medicine – Part 3: by Dr. Pritam Neupane

A series written by: Pritam Neupane, MBBS, FACP, FCCP – Memorial Hospital Pulmonology

Varying Roles of Doctors and Patients in Health Care

Doctors and patients play many different roles, sometimes more than one over the course of their relationship. In a scenario where someone is critically ill, the medical field describes the doctor/patient relationship as a “parent and a child.” The doctor takes the parent role, making the best decisions on behalf of the patient or child.

In such situations, patients are so sick they may not be in condition to make decisions for themselves and are usually admitted to the ICU (Intensive Care Unit). A typical example of this is a patient who has severe pneumonia and is comatose on a respirator.

Other times in more stable situations when there is time to discuss and debate, the relationship is described as a “parent guiding a teenager.” The “teen” understands, may have an opinion, and often times questions the parent as they come up with a plan or solution. A typical example of this is a sick patient in the emergency room with abdominal pain that is stable but needs surgery.

While managing long-term conditions, the medical field calls “chronic diseases,” the relationship is more like a friendship. These are conditions like high blood pressure, diabetes, arthritis etc. These conditions are typically managed in a clinic setting. Doctors provide advice and the best knowledge they have to offer, but taking care of these conditions by following recommendations, like taking medications and avoiding harmful situations, mostly depend on the patients.

Common Roles of Doctors and Patients in Health Care

With sweeping changes in healthcare in the United States after the implementation of each phase of the Affordable Care Act (more commonly known as Obamacare), health care delivery is not the same as it was in the past. Currently, hospitals and health care providers are regulated more than ever before.

While it sounds logical that the government will no longer pay for avoidable conditions or complications that occur in hospitals, hospitals and doctors are also not being paid for conditions that occur despite due diligence. Doctors will be penalized for bad reviews or for not clicking certain buttons in the computer. Soon health care providers and their clinics will see their reimbursement and sustainability affected for not reaching stated goals in certain disease conditions.

For example, if the patient’s blood pressure or diabetes is not adequately controlled, regardless of whether the patient followed recommendations or not. Medical professionals can only encourage not obligate their patients into following their recommendations.

These changes were brought about for the well being of citizens and to make hospitals and providers more accountable. While this should help the health care sector raise the bar of the care they provide, it puts equal responsibility on the patients. Providers alone cannot reach the goals of individuals unless they are supported by patients who indeed follow instructions and attempt to get well.

If patients give bad reviews because of their dissatisfaction with trivial matters rather than focusing on bigger more important health care goals, then providers may pick and choose the type of patients and insurance they want to deal with. This will be the exact opposite of the goal of health care in this country, leading to poorer health in general and greater disparity between the haves and havenots. So both doctors and patients share responsibility and accountability for individual health, reaching care goals, and respecting each other’s roles in health care.

Memorial Hospital of Sweetwater County is rapidly adapting to the current changes and ranks high on meeting the Affordable Care Act requirements. Providers are vigilant about new rules and strive to meet goals in all disease conditions. Patients are invited and encouraged to give proper feedback as well as understand the limitations of certain situations.

And of course, do not forget to work on your advance directives should you get into a child’s role, due to some unfortunate health circumstance.


For more information about vaccines and newly added medical procedures, check out my first post in this series.

For more information about some changes in healthcare over the years and planning ahead for your health and well being, check out my second post in this series.

Dr. Pritam Neupane sees patients in the Medical Office & Physician Clinic – Internal Medicine clinic. You can reach his office at 307-212-7711. Find out more information at All views expressed in this series are from the physician.