How do we get past the fearing our patients? Start by putting their needs at the center to rediscover mutual respect.

I just spoke up once again last at my local medical society meeting. The subject was Reach My Doctor, which is a platform for HIPPA compliant communication between doctors and doctors, and doctors and patients. In the past month, I got one of our local GI docs on board with me on this and he is hooked.

Getting my other peers, mainly the primary care providers, "hooked" is a completely different matter. They were very concerned with adding "another layer of things to do". "How do we keep professional bloggers from taking over our email?" they cried. "Will they not drive me crazy with midnight phone calls if I remove barriers from the care of my patients?"

I had to say something, and I feel that maybe one or two individuals heard what I was saying, which went something like this:  If we, as physicians, stop building more and more barriers to accessing our physician empathy and brain power, and treat patients the way we ourselves want to be treated, we will all be a lot happier, two way respect will start to take hold again, and we as healers, will be able to better help alleviate suffering.

Pain is an unavoidable fact of life. Death is an unavoidable fact of life. What we do to alleviate the human-made suffering is where it counts. That is where our healer talents, in combination with our scientific background, can actually make a difference.

Fear is reigning right now. I could hear it in the doctors voices. Doctors are afraid of patients. Doctors in general, have been forced by the current non system of health care provision to abandon the doctor-patient relationship, and I feel this very fact has made us frightened of what we have become.

Patients are afraid, not only of what the non system is going to do to them physically as well as the loss of control over their lives, but also what it is going to do to their life savings.

Doctors can alleviate the suffering that comes with fear through kindness, explanation, offering options of what to do, what will happen if this is done, and what will happen if nothing is done. Doctors wield and understand the technology. We must wield this understanding the fear it provokes and help lessen this fear.

Our patients are not widgets, and physicians are not commodities, but we, both the patients and doctors, currently bow to a non system that requires belief that humanity and its suffering can be reduced to entities/diagnosis that fit nicely in a box.

Suffering will not fit neatly into a box, a protocol or a simple flow chart. Flow charts and protocols are meant as guides as we individualize our care. They were not meant to BE the care. We must understand our patient populations not to make every one fit into the same protocol, but to be better able to advise them in their individual situation. THIS is the art of medicine.

If we start putting our patient's needs in the center, our collective suffering will begin to decrease, not through magic, but through genuine respect for the individuals that make up our world.

They all stared at me in stunned silence, but they were smiling, so I either had spinach in my teeth or maybe they heard something in what I said.

Megan Lewis, M.D.
Durango, CO

Comments

[Pamela Wible]

Awesome Megan!

[Beverley Kane, MD]

Dear Megan,

I found your blog via my Google Alert for "doctor-patient relationship." Good for you for speaking up! Many years ago I chaired a task force for the American Medical Informatics Association that created the Guidelines for the Clinical Use of Electronic Mail. It's been 10 years since publication, but the principles of respect, personal contact, and privacy still hold.

Currently I teach a course at Stanford called "Medicine and Horsemanship." We employ horses to teach bedside manner and other interpersonal skills for doctor-patient communication. (Also nurse-patient, etc.)

Please visit us at http://familymed.stanford.edu/predoctoral.html and
http://www.horsensei.com/

And keep speaking out for the principles that guided us when we went into medicine!

Beverley Kane, MD
Palo Alto, CA

[Sue Todd]

Well said. I also think physicians will rediscover more pleasure in their chosen profession because they are connecting and helping on an even deeper level. They will truly be facilitating the healing process if they use empathy. The sense of dissatisfaction a patient can feel when leaving the office can impact their health and their confidence in their physician. They are prisoners of health care because the limited amount of physicians available does not allow for shopping around for an empathetic physician.