Comments on: Is an efficient physician necessarily a good doctor?

By: Sarah

Sarah — Sat, 26 Sep 2009 18:49:24 +0000

“Compassion can be useful in laying the foundation for good communication; good communication may speed the way to a correct diagnosis, and therefore impact efficiency.”

I think W’s got it completely right. To me, a compassionate doctor is one who takes the time to listen to me and then acknoweldges in some way that he/she has listened to me. Maybe that second part (acknowledgement) isn’t strictly necessary for the doctor to make an accurate diagnosis, but it helps me to assess whether the doctor is really taking all information into account.

For instance, I remember talking to my gastroenterologist after my colonoscopy (vaguely, because i was still sedated), and he asked me whether the fiber pills were helping. I said i had not noticed any difference. He said, “Well, keep taking them,” and left. What was i to make of that? (Had i not been zonked out, i’d have thought to ask. Instead i switched to an acupuncturist.)

By: arb

arb — Mon, 21 Sep 2009 15:42:23 +0000

As a patient, I would say – yes, compassion is necessary, taking time with patients is necessary. It was because of a compassionate doctor that I returned for follow up care, allowing a lymphoma diagnosis that defied blood work (it was normal – but other symptoms persisted and the physician who had known me my whole life believed me, did not dismiss me, and CALLED ME to ensure that I returned for additional testing). It is because of the hurried, efficient, compassionless environment of current primary care that I have become so disheartened that I no longer have a primary care physician (but, specialists aplenty) to call home.

I am certain that had I presented my symptoms (this was 20 years ago – I was 20) to any of the pcp’s I’ve auditioned in the past few years that after the blood work came back as normal that my other symptoms would have been dismissed, metaphorically patted on the head and told to run along now. I am fortunate to be in excellent health. My specialists joke that I only seem to get catastrophic illnesses. (I have had additional unrelated cancer dx in recent years). My BMI is 19, my BP 90/60, my cholesterol superb. I eat a varied mostly plant-based diet and exercise regularly.

The relationship between a physician and patient is an important component of care. To be sure, compassion and its resulting relationship are less important in short term interactions – surgery, for example – but in primary care it is my opinion that compassion is as important as clinical skill.

It doesn’t take much to forge a relationship with a patient. A few random questions, unrelated to health care, a brief conversation (doesn’t have to last long) can be all is required. Show your humanity.

I have no doubt that most of the doctors reading my post (if they even bothered to read past the “as a patient” part) will dismiss my comments as irrelevant, without foundation, reflecting an uneducated, ignorant individual with unrealistic expectations from her physicians.

There is a lot of commentary from physicians on this and other blogs that complain of the lack of respect the public has for doctors these days. I would argue that the lack of respect for patients by physicians is even more prevalent in the blogoshphere and, really, far more harmful to medicine.

By: Doc Stone

Doc Stone — Sun, 20 Sep 2009 22:04:36 +0000

The doctor-patient relationship is one of the two constants in medicine that precedes biotechnology and supercedes it outcome for many conditions. The quality of that relationship profoundly influences not just patient satisfaction and compliance but also profoundly affects the patients of sense of overall well-being. It is as critical an element of healing as choosing the right drug–for some conditions, more critical. And is founded to a great degree on the patient’s sense that the doctor has compassion towards them.

By: Nurse K

Nurse K — Sun, 20 Sep 2009 20:36:02 +0000

A lot of the doctors that I take issue with have plenty of time, but choose to spend it sitting around doing nothing rather than talking with the patient or doing an exam. The same doc that I’ve never seen lay hands on a patient/palpate an abdomen/listen to a heart is on the Internet reading about his hobbies. If all you’re going to do is order maximal tests anyway, why bother getting a good history/exam? Layzeeness is certainly a factor!

By: jenjen

jenjen — Sun, 20 Sep 2009 19:18:17 +0000

Genuine compassion may not be necessary. But a physician lacking all ability to at least fake it is not likely to get my repeat business. Especially in primary care.

By: W

Sat, 19 Sep 2009 21:28:34 +0000

Compassion can be useful in laying the foundation for good communication; good communication may speed the way to a correct diagnosis, and therefore impact efficiency.
Have had the same PCP since the late 1980s. Never felt even marginally connected to him until a physical several years ago. His office had just gone “electronic” that very day, and it didn’t seem to be going smoothly. He tried to print a prescription for me from his PC, then realized he didn’t know where the printer was. He left the room and came back a few minutes later holding the printout, which had a big footprint on it.
“This is what improved technology looks like,” he said. “You get your scrips after we’ve walked all over them.”
Knew he was the right doctor for me when I saw he could laugh at himself and such circumstances. Don’t underestimate the impact it can have on patients to let them see you’re human.

By: Bruce Small

Bruce Small — Sat, 19 Sep 2009 18:41:29 +0000

Our current doctor, who is wonderful, has both qualities. Nice as could be, and superb at diagnostics.

Our previous doctor was all but useless.

By: Kevin

Kevin — Sat, 19 Sep 2009 18:04:21 +0000

Thanks. This has been corrected.

Kevin

By: Is an efficient physician necessarily a good doctor? « The ACUTE CARE Blog: Non-Urban Emergency Medicine

Sat, 19 Sep 2009 18:03:05 +0000

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By: Just a Number

Just a Number — Sat, 19 Sep 2009 15:58:39 +0000

I was denied a diagnosis because of efficiency. As I told my story, the harried physicians stuffed me into a box that I did not belong. Even after a diagnosis was made, the urgent care doctors, too busy to read my chart and listen to what I had to say, misdiagnosed me again and again.

Not one MD helped me regain my quality of life-all they had time for is prescribing medication. I found my answers on the internet and with alternate providers.

While I would prefer a doctor with clinical excellence, I don’t see how you can provide excellent medical care if you don’t have the compassion to listen to your patient. Box anyone?