The doctor – patient dialogue

The doctor frequently uses words that have no meaning to the patient, since they are not tangible to him.

The dialogue with other members of the care team (in particular with those of a lower hierarchical level) is often more open, since the patient knows that his/her discussion with this caregiver will have little or no effect on his/her treatment, and therefore on prognosis.

As soon as a patient suspects that he has cancer, he often flees from the truth, whilst valiantly clinging to the therapist likely to save him.

The relationship between the patient and his doctor becomes dependency-based, and the patient avoids asking any questions that may offend or spoil the bond that he is convinced he has built with his doctor. He would rather ignore his problems, ask questions elsewhere or change doctors without letting his initial physician know.

It has been estimated that less than 10% of cancer patient consultation time is spent on replying to the patient’s specific questions.

Thus, the doctor who announces cancer diagnosis is often held in contempt: unconsciously, the patient scorns he who confronted him with the unbearable reality. Occasionally, the patient may also reproach his doctor for late diagnosis, whilst it is, in fact, the patient himself who is often responsible for any delay.

For these reasons, the doctor himself fears confrontation with the cancer patient, and the manner in which he announces diagnosis or suspected diagnosis, often lets his own personal anxiety and nervousness transpire.