Wednesday, August 8, 2007

Being a physician means...

Medicine has been my life’s work for over 40 years, full time for all but 12 years. For 20 years I practiced general internal medicine, and 12 years were spent in emergency rooms and urgent care facilities. It is from this broad experience that my opinions and observations are drawn. I have experienced medicine before and after the introduction of managed care and have seen the effects or market forces on my profession. As you will see in the progression of this blog I am critical of many of these effects.

The opinions I express are mine alone; I do not claim to speak for any group, association, or other formal agents of the medical profession.

What follows was written for my daughter Beth who practices internal medicine in Delaware. She is a wonderful physician (an absolutely objective opinion) and I am immensely proud of her.

1. Be yourself

Patients know that you are the doctor, so there is no need for posturing or being doctorish. Just be yourself, comfortable and relaxed, and talk to or with the patient as you would with a family member or friend. Don’t be afraid to share some of yourself with the patient, it will greatly enhance the relationship, put them at ease, and encourage them to be more open with you. Don’t hide your person behind the persona of the physician.

2. Smile

If there is any one single thing you can do to help a patient (or anyone else) feel comfortable, it is to smile. Nothing is more intimidating than a somber or stern appearing physician approaching a patient, especially one is sitting there partially or completely disrobed and overwhelmed by some specific concern or worry. And, unless the clinical circumstance dictate otherwise, or your own personality precludes it, use humor as a tool to win the patient’s confidence and help put them at ease. There is no reason why a visit to the doctor’s office can’t be pleasant, if not fun.

3. Be attentive

The patient deserves all of your attention. They have only a few precious minutes in which to tell their story, and they need to know that you are listening. It is not necessary to sacrifice this in order to use time more efficiently.

4. Anticipate a patient’s fear or concern

It is not always enough to listen to the patient’s complaints; sometimes it is necessary to anticipate those fears and concerns that they are unable to articulate. For example: a patient with an obviously benign symptom may have a real, hidden fear of cancer, so great that they are unable to even ask about it. It is a good habit to end each patient encounter with the question...”do you have any questions”, or, “have I addressed all or your concerns, or even, is there something you are really worried about or afraid of”?

5. Be respectful

Being a physician does not give us the liberty to disregard the usual rules of etiquette and behavior. Unless invited to do otherwise, address all patients, especially those older than you, as Mrs. or Mr.. A good general rule is: if you wish to be called Dr.....then address your patient as Mr. or Mrs., or Ms. Once a long term relationship has been established, first names may become appropriate.
Respect children and adolescents. Address your questions to them and not their parents.

6. Be tolerant of the weaknesses of others

Accept people for what they are, and do not be too quick to judge them if they don’t meet your own standards of behavior, lifestyle, and living habits. Remember, everyone is entitled to poor judgment. Your task is simply to make sure that they have the right information on which to make that judgment. Don’t get in a snit if a patient doesn’t accept your wise advise.

1 comment:

Beth said...

My dear Dad,

You haven't just written this list, you have taught it by example your whole life -- thank you

p.s. have I told you that I love you today?