Doctor-Patient Relationship Must Remain Primary

I much appreciated “Ethical and Intrapsychic Issues in Ending a Practice” in the July 21 issue by Dr. Norman Clemens.

Dr. Clemens wrote eloquently about the value of and respect for the doctor-patient relationship and its positive impact on patients. I am very concerned in our age of IT and electronic health records that privacy and confidentiality are erroneously viewed by many policymakers as anachronistic and even counterproductive to doing “collaborative care.” And, when devising and implementing population-based health care policy funding with pay-for-performance incentives for psychiatrists, the patient’s (and doctor’s) personhood and unique interpersonal dynamics are bypassed as a powerful therapeutic tool and may be turned against the patient when doctor and patient are not be in a safe place for disclosures. How will future professional relationships matter in psychiatric practice? We need to keep our eye on this question.

I recall with pleasure and gratitude Dr. Clemens’ excellent work when we were colleagues on the APA Joint Commission on Government Relations and served as our state representatives to the APA Assembly.

LEE H. BEECHER, M.D. (Maple Grove, Minn.)

(Lee H. Beecher is president of the Minnesota Physician-Patient Alliance.) ■