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The lessening of emotional bonds which characterizes today’s physician-patient relationships is a major cause of malpractice litigation, and the empathy we used to feel has been replaced by a healthy fear of lawsuits. (The only response that makes sense is to get into a defensive mode, and order more tests, consultations and follow up exams than you really think are necessary.) Practicing defensive medicine requires being counter-intuitive, not listening to your “gut” reactions, repressing your emotions and acting joylessly from a place of fear. It is not possible to make an accurate diagnosis and proceed with appropriate treatment in a cost effective manner from a defensive posture, and doing it certainly takes a lot of the fun out of doctoring. No one can guess how much health care costs would drop, and the quality would improve, if the threat of baseless lawsuits disappeared.
Physicians, more than any other professionals, have seen death first hand and have dedicated our lives to forestalling it. We are conditioned to look for new treatments and therapies, and we as a group are the least accepting of our own or anyone else’s death. We have posed death as the enemy, and we are usually less than graceful when our role shifts to engineering a “good death”.