In the intricate world of healthcare, the relationship between doctors and patients is often seen as one of collaboration and trust. But beneath this surface lies a power dynamic that can profoundly influence the care patients receive. This imbalance of power is a subtle yet pervasive issue that can undermine patient outcomes, particularly for those from marginalized groups.

As someone who has faced significant health challenges over the years, I’ve had firsthand experience with this power differential. My health journey has included fifteen major surgeries, two bouts with breast cancer, chronic migraines, irritable bowel syndrome, mental health struggles, and more. Through these experiences, I’ve interacted with countless medical professionals in various healthcare settings, encountering both compassionate care and the detrimental effects of a skewed power dynamic.

Understanding the Power Imbalance

The power disparity between doctors and patients isn’t always overt. It can manifest in subtle ways, like a doctor dismissing a patient’s concerns or making decisions without fully considering the patient’s preferences. In other cases, it’s more explicit, with doctors using their authority to dictate treatment without engaging in meaningful dialogue with the patient. This imbalance is particularly pronounced for minority and marginalized groups, who often face additional barriers in having their voices heard and their needs met. Doctors and other providers may unknowingly contribute to these health inequities through their unconscious biases.

When doctors wield disproportionate power, it can lead to adverse outcomes for patients. Decisions made without patient input can result in treatments that don’t align with the patient’s values or lifestyle, leading to poor adherence and outcomes. Additionally, patients may feel disempowered, less likely to speak up, or even mistrustful of the healthcare system, further exacerbating the cycle of poor care.

Certain dynamics exacerbate the power differential. Many patients don’t have as much education as doctors and other medical professionals and may feel intimidated. Women, especially those in older generations, have been socialized to think that “doctors know best” and they shouldn’t challenge medical professionals’ opinions. Depending on the circumstances, patients are likely not feeling their best and, in some instances, are feeling downright miserable. It’s hard to advocate for oneself when you’re feeling lousy.

Furthermore, providers often use medical jargon that patients may not understand, leaving them drinking from a fire hose in what’s essentially a foreign language. In addition, body language speaks volumes. When patients are lying down, doctors standing above them and looking down on them can be unnerving especially when the patient is in a hospital gown and already feeling vulnerable. The same is true of doctors who don’t make eye contact and spend nearly all of an appointment typing into a computer instead of connecting with the patient. Such behavior can be very demeaning, especially when a patient has waited many months to meet with this particular specialist.

Moving Toward Collaboration

Addressing this imbalance requires a shift in how both patients and healthcare providers approach the patient-provider relationship. Patients must be empowered to advocate for themselves and armed with knowledge and confidence to participate actively in their care. Meanwhile, doctors and other healthcare professionals should adopt a more collaborative approach, recognize the value of the patient’s perspective, reduce their use of confusing medical jargon, and avoid demeaning behaviors. By understanding the nuances of this power imbalance, we can work towards a healthcare environment where patient voices are not just heard but valued, leading to better outcomes for all.