There are three major trends that are changing our nation’s healthcare needs and our patient population. First, the increased diversity in the American population as a whole (from immigration, increased social and academic mobility, and interconnectedness through technology) puts us in front of patients whose thoughts and beliefs about health and well-being may be starkly different from our own. Second, increased access to healthcare through reform legislation has allowed millions of Americans to reach providers for the first time. Finally, our successes in medicine and public health have increased survival rates of many formerly fatal conditions and have enabled us to live longer. This leaves us with an aging population, in which individuals may be coping with multiple illnesses simultaneously.
To arm physicians of the future with the skills needed to take care of this population, many medical schools are increasing their coursework in interpersonal skills (Doctor–Patient Relationship; Doctoring; or Physician, Patient, and Society are such courses at various schools), as well as cultural sensitivity, the recognition and respect of differences between cultures, and research ethics. This is part of the biopsychosocial model of medicine described in Chapter 7 of MCAT Behavioral Sciences Review. Knowledge of the structure of society and how it shifts over time, as explained in this chapter, will enhance your ability to counsel patients. Unlike the old model of doctor knows best (often referred to as the paternalistic approach to medicine), today’s doctors must work together with patients to find solutions to their health problems. By working with patients on their own terms, you will be able to help maintain and improve their health status and begin to correct the health inequities that exist in today’s population. In the next chapter—the last of MCAT Behavioral Sciences Review—we will explore these inequities in resources, health status, and healthcare.