研究：醫患“互粉”對治療不利

Friendly doctors are 'bad for their patients' health', researchers have warned as a new study revealed two thirds of young medics struggle to be truthful with patients they like.

最新研究表明，醫生態度友善反而對患者治療不利。三分之二的年輕醫生很難對他們喜歡的病人講實話。

Blurring the lines between social and professional relationships can impact on the level of care offered and prevent patients from being honest about important side effects.

醫生與病人之間的社交和專業界線模糊不清會影響病情治療，且病人也不能清楚地瞭解治療產生的副作用。

Doctors should refrain from adding patients as friends on Facebook, they should not hug or allow patients to call them by their first names, regulators have warned.

監管者告誡醫生，不要在臉書（Fackbook）上加病人爲好友，同時也不要擁抱病人或是允許病人直呼他們的名字。

They said those who breach the boundaries could face disciplinary action.

監管人員提醒說“越界”的醫生將會面臨處罰。

It comes as a survey of 338 oncologists under the age of 40, published in The Lancet Oncology, found 59 per cent said they found it difficult to tell the truth to those patients they liked.

這項發表於醫學期刊《柳葉刀腫瘤學》（The Lancet Oncology）上的研究調查了338名40歲以下的腫瘤醫生。調查顯示，有59%的醫生表示很難對他們喜歡的病人講實話。

Sixty per cent of respondents said if doctors felt too close to their patients, it could prevent them from making objective decisions about a person's care.

60%的受訪者認爲，醫生與病人之間太過親密將會影響醫生對病人的治療做出客觀的決定。

Lesley Fallowfield, of Brighton and Sussex Medical School, said: 'Oncology is a specialty that can be enormously rewarding but is fraught with many challenges.

來自布萊頓蘇塞克斯醫學院（Brighton and Sussex Medical School）的萊斯利·法洛菲爾德（Lesley Fallowfield）說：“雖然腫瘤學能帶來豐厚回報，但卻充滿了許多挑戰。

'Young oncologists have to master dealing with anxious patients who are facing a life-threatening disease; conveying the true prognosis; discussing the complexity of modern treatments; and explaining the unavailability of some drugs, the side-effects of treatment, and likely therapeutic aims.'

年輕的腫瘤醫生必須要掌握以下幾點：一是學會緩解那些患有危及性命疾病的病人焦慮的情緒；二是告知病人真實的預後症狀；三是與同僚積極探討現代醫學治療的複雜性；四是對人們闡明藥物不可使用的情況、治療產生的副作用以及治療的目的。”

But she said for those doctors who have entered the profession in the age of the 'cyber world', are more likely to fall victim to blurring the professional boundaries with patients.

但她認爲，對那些在“網絡時代”進入專業領域的醫生們來說，醫生在與病人相處時很容易越界。

She said: 'The difficulty, if you hug and kiss patients, if you allow them to call you by your first name, is that quickly the relationship can become confused as a social one rather than a professional one.

她說：“如果醫生擁抱親吻病人，或是允許病人直呼他們的名字，那麼當醫患關係變成朋友關係時，就很容易模糊醫生與病人之間的那條界線。

'Doctors become confused, "I really like this person, how can I bear to tell them that they're going to die?"

醫生們會很困惑，因爲他們不知道要如何告訴與自己相交甚好的病人，他們即將要面臨死亡的事實。

'They find it more difficult to be objective.'

到那個時候，他們會很難做出客觀的抉擇。”

Professor Fallowfield said while doctors can find it harder to be truthful, and break bad news to patients, blurring the professional lines can impact on the patient's behaviour too.

法洛菲爾德教授表示，這樣一來，不僅醫生很難對病人講實話、給病人帶來不好的消息，對於病人來說，醫患關係不明確也會影響他們的行爲。

She said those being treated can 'feel intimidated about complaining', or fail to raise issues regarding unpleasant side effects of treatment, which could prove vitally important.

她說，病人會感到“不敢抱怨”，也無法提到有關治療的不良副作用。這些對病人來說，都是極其重要的。

The study found half of doctors questioned had given patients their personal mobile numbers, a fifth had accepted social invitations from patients and 14 per cent had accepted them as friends on Facebook.

調查表明，半數醫生曾將私人號碼留給病人。五分之一的醫生曾收到病人的社交邀請，14%的醫生則在臉書上加病人爲好友。

A spokesman for the General Medical Council, which regulates doctors, said: 'The rise in the use of social media also brings new challenges and doctors must consider the risks involved and the impact it could have on the relationship with their patients.

醫生監管機構醫學總會（General Medical Council）的一位發言人說：“社交媒體的興起帶來了許多新的挑戰。因此，醫生必須要考慮到其中的隱患，以及醫患關係對病人的影響。