Spark [Robert_Klitzman]_When_Doctors_Become_Patients(Boo | Seite 316

Conclusions 305
This phenomenon has several ramifications. America as a whole is
becoming more spiritual; fundamentalists and conservative Christians
have exercised political clout, spurring antagonism toward science
among many Republicans. Beliefs in creationism and intelligent design,
as opposed to evolution, flourish. The data here suggest that these beliefs
cannot be fought simply with science. Rather, mythologies and magic
remain deeply ingrained in human needs and psyche, and no doubt will
always exist and prompt wariness toward science. Science is making in-
roads, but perhaps will never be able to rule wholly. Critics of the Re-
ligious Right may benefit from grasping as fully as possible the complex
roles of magic and irrationality in the psyches of even scientifically-
trained physicians, to understand the fears and psychological pressures
that help fuel these beliefs.
Are Doctors Bad Patients?
Since starting this project, I have often been asked whether doctors make
better or worse patients. Many people assume the latter. Yet in the end, I
realized that doctors as patients are different—in some ways better, in
other ways worse.
This question, though, raises others that are far more important: After
all, what is ‘‘a good patient’’? Is it indeed one who ‘‘leaves the doctor
alone’’? If that is the definition, at least in the minds of many health
care providers, then numerous implications emerge for patients, families,
health care delivery, and educators. Should other models be promul-
gated, and if so, what? For example, the definition of a good patient could
be based in part on health outcomes. Yet, if that were true, ‘‘bad pa-
tients’’ might then merely be the ones who get sicker. Are good patients
those who are more adherent? That view may reflect attitudes about the
primacy of physician authority. Doctors may even communicate this
expectation to patients. But patients who disagree with their physician
are not necessarily ‘‘bad’’ (especially given how much doctors may dis-
agree among themselves, for example, in aggressiveness or nihilism).
In confronting disease, these doctor-patients both resembled and dif-
fered from lay patients. Clearly, they have more medical knowledge than
lay patients. The latter may ‘‘self-doctor’’ in certain respects; but only
physicians can order their own tests and prescribe medications. Physicians