A doctor has criticised the medico-legal system as a dysfunctional process which, by its very nature, makes people ill.
Dr Leonard Condren, who gave the Foundation Lecture at the ICGP annual meeting in Westport yesterday, said there was a conflict between a patient's visit to a solicitor, seeking redress for an injury, and the same patient's visit to a doctor, looking for relief from the symptoms caused by the injury. The doctor's efforts to minimise the patient's level of disability and pain conflicted with the legal system's cultivation of a "victim mentality".
Dr Condren, medical editor of Irishhealth.com, recently announced that he was leaving general practice.
Taking the theme of the doctor-patient relationship as an ecosystem under threat, Dr Condren said a number of inputs could potentially damage the well-being of this biological system.
He criticised the restricted funding mechanism for general practice which relied on drug savings by doctors to fund practice development. "The vast bulk of the investment in the infrastructure of Irish general practice has come from the pockets of general practitioners," he said.
Turning to the managers of the health service, he told the meeting: "I am unhappy with the level of support from our local health boards - they remind me of a dysfunctional family."
Dr Condren also questioned the notion of "customer as king" in the doctor-patient interaction.
The idea that "you can have whatever you want, whenever you want it, is not compatible with personal medical care", he said. "We need a new understanding with the people we serve. There needs to be an accommodation between the limits of what we can provide and the expectations that people have."
Another threat to the relationship between doctors and patients was computerisation, according to Dr Condren. "Has the computer shifted the dynamics of the consultation from a patient-orientated to a doctor orientated one?" he asked.
He predicted that in coming years, medical card lists in deprived urban areas would be difficult to fill, because doctors would decline to work in "harsher urban environments" if they were not paid more to do so.