How Can Doctors and Patients Truly Work Together?

By Dr Win Huang, PhD (Chinese Medicine & Acupuncture)

There is something interesting about clinical practice.

Doctors and patients usually want the same thing: for the patient to get better. So why do misunderstandings, doubts and dissatisfaction still occur so often?

The reason, I think, is that although the final goal may be shared, doctors and patients stand in different positions. They see different parts of the problem and carry different responsibilities.

A patient spends time and money seeking treatment and naturally wants to recover as quickly as possible. A doctor also wants the patient to improve. A clinician who repeatedly fails to help patients cannot build lasting professional trust or reputation.

In that sense, doctor and patient should be on the same side.

But differences begin as soon as the consultation starts.

Patients Know Their Symptoms; Doctors Should Understand the Disease

Patients know their own experiences better than anyone else. They know where it hurts, when numbness appears and what makes them uncomfortable.

Their understanding of the disease, however, may come from symptoms, previous doctors, friends, websites, social media and increasingly AI-generated health information.

Some of that information may be accurate, but it often represents only part of the picture.

A clinician has a different responsibility. We need to ask where the symptoms may be coming from, what alternative diagnoses should be considered, how serious the condition may be, whether it could progress, and whether treatment, further investigation or referral is appropriate.

I often think of it this way:

The patient knows their symptoms best. The clinician should understand the disease more deeply.

Both forms of knowledge matter, but they are not interchangeable.

Feeling Better Is Not Always the Same as Full Recovery

Patients often judge recovery very simply: the pain has gone and normal activity has returned, so the problem is resolved.

Clinicians may need to look further.

Pain may have largely disappeared while tenderness remains. Movement may have returned while strength, reflexes or sensation remain abnormal. Symptoms may have improved while blood tests, imaging or other findings still require monitoring.

The clinician may therefore recommend further observation or treatment.

The patient may reasonably ask:

“I feel fine. Why do I need to come back?”

When additional visits also mean additional time and cost, another question can easily arise:

“Does the doctor just want me to have more treatment?”

This is a genuine source of tension.

For that reason, clinicians should not simply say that treatment needs to continue. We should explain why, what we are monitoring, and what would indicate that treatment can stop.

A Negative Test Can Still Be a Useful Result

Patients may also assume that if a doctor orders blood tests, an X-ray or an MRI, the test should find something abnormal.

If everything comes back negative, they may wonder why the investigation was necessary.

But an important purpose of medical investigation is sometimes to rule out disease.

The clinician may not be trying only to prove what a patient has. We may also need to establish what the patient does not have.

Excluding inflammatory disease, infection, malignancy or another important condition can substantially narrow the diagnostic possibilities.

A negative test therefore does not necessarily mean that the test achieved nothing.

At the same time, this does not justify unnecessary investigation. Tests should still be guided by the history, examination and clinical reasoning.

More Treatment Is Not Necessarily Better Treatment

Another interesting contradiction appears around treatment.

Patients may worry about too many tests, yet sometimes feel that more treatment means better treatment.

More medication can look more thorough. A complicated procedure may appear more advanced. In acupuncture, a patient may wonder why only a few needles were used.

But medicine does not work according to quantity.

Some conditions require complex treatment. Others may require very little.

The principle should be simple:

Do what is necessary—no more and no less.

The value of treatment lies in whether it is appropriate, not in how much is done.

A Patient Is Not a Car

There is another important difference: responsibility.

Sometimes a patient understandably thinks, “I have come to the doctor. Now it is the doctor’s job to fix me.”

That resembles taking a car to a mechanic. The mechanic repairs the car; the car itself does not need to participate.

Human beings are different.

A person may develop back or leg pain after standing for very long hours but continue the same workload after treatment. Someone may suffer from chronic fatigue while refusing to change severe sleep deprivation. Smoking, alcohol, physical overload and persistent stress may continue despite repeated treatment.

A clinician can provide treatment, but cannot sleep for the patient, rest for the patient or change how the patient uses their body every day.

Treatment therefore should not simply mean:

“The doctor fixes the disease.”

It should mean:

“The clinician and patient work together to manage the problem.”

Trust Has Responsibilities on Both Sides

How, then, can we reduce these conflicts?

For clinicians, I believe the foundations remain professional competence and ethics.

We should continue improving our knowledge and clinical skills while trying to remain medically impartial. We should not perform a treatment simply because we can offer it, nor should we provide something merely because a patient requests it.

Investigate when investigation is justified. Avoid it when it is not.

Continue treatment when there is a clinical reason. Stop when it is no longer necessary.

Refer when referral is appropriate.

Clinical decisions should be guided by medicine, not by financial interest.

Patients also need to choose clinicians carefully. The loudest advertising and strongest promises do not necessarily indicate the best care.

Patients have every right to ask questions, express doubts and seek a second opinion. But once they decide to work with a clinician, there also needs to be enough room for professional judgement.

The ideal doctor-patient relationship is not about deciding who must obey whom.

It is about recognising:

We stand in different positions, but we are working towards the same goal.

The clinician must become worthy of trust.

The patient must learn how to place trust wisely.

When both are present, many of the conflicts that seem difficult in clinical practice become much easier to resolve.

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