The patient-provider privilege


Image courtesy of Smiley Pool Photography

In my opinion, one of the greatest privileges health professionals get to experience when they begin their clinical practice is being allowed and brought into the lives of their patients. This is especially true in obstetrics and gynecology. What begins as a relationship between strangers quickly morphs into an intimate and trusting interaction between two individuals – a physician and a patient. The nature of this relationship demands immediate trust, as patients will often unveil their innermost secrets and insecurities, as well as their strengths and capabilities.

In my training and work, I’m continuously reminded of this incredible transition. One moment, my patient is a new, unknown name and face. The next, we’re discussing her relationships, her pregnancy, her family and often her other social and personal struggles. I’ve always felt this level of knowledge about a person’s private life is an honor and large responsibility to guard and protect throughout the clinical relationship – which can be brief or prolonged, depending on circumstances.

In my current work with women suffering from obstetric fistulas, I’m learning this patient-provider relationship is all the more fragile and, thus, all the more important. Not only are my patients immediately sharing their life experiences with me as they walk through the door, but they’re also sharing their trauma with me. They have often gone through horrendous labors and births, lasting sometimes up to five days as they struggled to find a place for help during an obstructed labor.

Nearly 90 percent of my patients experience a stillbirth with the same pregnancy that caused the obstetric fistula. While this must have been difficult enough, they begin to uncontrollably leak urine and sometimes feces from their fistula. For many of these women, their relationships are unfortunately broken, and they struggle to participate in social interaction the way they used to. Somehow, though, they find a way to overcome their tragedies and gather the strength to seek help. The risks they take to find their way to our hospital – to tell us about their physical problems, and to trust medical providers – are risks I cannot imagine taking.

While protecting their privacy and ensuring confidentiality, I think their stories are important to tell. Sharing their experiences is the only way to let everyone know we all need to be working harder to improve maternal and reproductive health care to make things better for women everywhere, across the globe.

If you’re interested in learning more about Texas Children’s Global Women’s Health, alongside many other Texas Children’s Global Health programs, click here.