Judging from discussions in medical journals and at professional meetings, pediatricians and other physicians are increasingly aware of their relationships with patients, patients' families, medical co-workers, laboratory personnel, insurance company representatives, legislators, regulators, lawyers, reporters, students, and spouses. There is, however, little discussion of a central relationship that affects all the others: the physician-doctor relationship. It arises because "physician" is not a description of a person, but rather of a role that a person—the doctor—plays.

PHYSICIANS AND DOCTORS

The doctor's coat, stethoscope, and title are a costume that facilitates the performance of the role of physician. It helps the doctor and others to suspend disbelief that this person is a physician: objective; busy yet available; knowledgeable, skilled; undaunted by always private, sometimes smelly, and occasionally fatal problems. These traits of the physician are often important to filling the role, because they allow patients to entrust themselves to the physician, and the doctor to accept the trust and to go on when the going gets tough.

But the traits of the physician contrast sharply with those of the person who fills the role of physician—the doctor. That person is, like other people, subjective, unavailable when busy, often ignorant and unskilled for the job in hand, and likely to be upset by personal and life-threatening problems. The discrepancy between the traits of the doctor (a person) and the physician (a role the person plays) gives rise to a rélationship (the physician-doctor relationship) that is central to what physicians do. Understanding this central relationship is likely to be both important and interesting.

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