Invasion of Patient Privacy, Physical and Historical: Are Doctors Unaware?

There has been at least two issues that I have presented on my blog where the responses of the visitors have given me professional and ethical pause. I mean I have been made aware that there are some strong feelings and attitudes that patients carry which has never been previously stressed to me nor, I think, to other physicians. As the example, I have had the discussion of physical modesty of patients in relation to their interaction with their physicians. There were some strong concerns about unprofessional physician behavior in this regard. And the last posting was about physician history taking, specifically about taking a history about firearms in the household. The suggestion was made that some of the questions which physicians feel are important medical questions may not be considered as such by some patients. In this post, I don’t intend to defend the merits of the unhappiness by some patients regarding these issues or the merits of any physician’s rebuttal. What I am concerned about is that this may be just the tip of an iceberg of ignorance of what we physicians know (really don’t know) about how patients feel about our behavior as we treat them. Is this ignorance because we physicians just don’t listen or is it because patients don’t talk to their doctors about it? Whatever the reason, this ignorance on our part is not a healthy condition to lead to the best relationship with the patient. If the patient is unhappy about what the patient feels is the physician’s disregard for their physical modesty or thinks that the doctor is unnecessarily invading the patient’s privacy by asking unnecessary questions or even other issues that I haven’t even mentioned, this can be a obstruction to any attempt at the best of medical care. Also, as a teacher of medical students, I wonder,in this regard, if our medical schools need to emphasize certain issues of patient concern which we have not emphasized in the past. Any thoughts on this subject? ..Maurice.