Dr. James Todd is the American Medical Association's senior deputy executive vice president. Until he took on that cumbersome title, he was a practicing surgeon highly regarded by his patients for care and concern.
I recently asked him, "What is the single most important thing for a patient to know in dealing with today's doctors?"
"The most important thing is bilateral full disclosure," disclosures by both doctor and patient, he said.
"The patient has a right to know the physician's training and credentials, his charges, his availability" -- office hours, how to reach someone nights and weekends -- "and what he expects to do for you.
"In order for the physician to give the best health care, he has to know all there is to know about you -- your medical history, fully and honestly, your economics, what you expect.
"Either the doctor or the patient who rebels under these conditions really ought to do something else."
Do some patients fail to tell doctors all they should, or actually lie?
"Oh, yes. You'd be amazed how many people today deny that they smoke. Or about their alcohol consumption. Or how much they exercise. Or about their family history. They often don't want to mention diabetes, hypertension or particularly cancer.
"Or about why they're really seeing me. Sometimes I'd sit in my office and know that what the patient told me wasn't the real reason he or she was there, and I'd ask myself, 'Why is this patient really here?'
"I also want to know about the patient's family. I can't take good care of patients if I don't know their family, their uncertainties, their ambitions, their background. I have to deal with the family if I am to deal with the patient."
There is a difference in today's patients, Todd says. "They're more inquiring. They want to be involved in their own management."
But there is also "a great variation." Some of us want to know a great deal about our medical problems and our care, some very little. "You need to find out what the patient wants to know," Todd says. "In some way, you have to tell us."