Physician characteristics that are universally appreciated

The relationship a physician has not only with their patients, but also with their patient’s families, has long been the foundation of the medical system.

Over the course of time this once valued bond has had its ups and downs; however today with the internet, Obama healthcare reform, and Medicare cuts to name a few, the doctor-patient relationship finds itself in its most fragile state. This past week I was exposed to both extremes of this delicate relationship, and realized there is still much to be learned by both physicians, patients, and their families alike in order to keep this foundation from collapsing.

Physicians, contrary to popular belief, are humans. We are not Gods, heroes, or miracle workers. We are ordinary humans who through knowledge, training, and experience have developed an understanding of the intricacies of the human body, its function in health, and its dysfunction in disease. We have dedicated most of our lives to this process, at the expense of our own family and friends, mainly because we love helping others and care about our patients (most of us anyway). Though at times capable of some amazing things, in the end we are all just human—imperfect, and prone to make the occasional mistake.

Just as each patient has their own unique personality, each physician also has their own unique personality. Therefore it’s virtually impossible to make any generalized assertions as to what personal qualities of a physician are likely to make each individual patient feel at ease. There are some who prize their doctor’s compassionate, friendly manner; others who are more comfortable with a more formal, professional stance. Some like an authoritative, take-charge manner, while others prefer more of an equal relationship, where their participation in decision-making is freely elicited, and reciprocity ensues.

There are some characteristics, however, that are universally appreciated and should be displayed by all physicians: spending enough thorough time with the patient; sharing, without restraint, your reasoning process and expertise on treatment decisions; being open to questions, no matter how technical on the one hand, or uninformed on the other; treating family members with consideration; and being available in a reasonable time frame both during and outside of office hours.

The trust between the doctor and the patient needs to be rebuilt. News reports about medical errors and drug industry influence have increased patients’ distrust. Drug advertising targeted directly to the consumer along with medical web sites have taught patients to research their own medical issues, making them more skeptical and inquisitive of their physicians. Current medical science and technology have given physicians new tools to treat diseases and to keep patients alive for longer periods of time than would be possible in the past.

However, there are times in the management of the patient’s illness when the physician finds that further energetic diagnostic tests or treatment to attempt to treat the disease or try to prolong life would be futile. A treatment might not be expected to work or an expected outcome would be unlikely, particularly if the resultant quality of life would be considered poor. The treatment might, instead of prolonging life, only prolong a difficult dying. But there is still controversy amongst physicians and amongst patients along with their families as to what futile means and when a procedure or treatment can be called futile. Physicians may find one treatment approach futile but the patient or family member may disagree and deny futility. Occasionally the opposite occurs with the physician resisting discontinuing a treatment. What is needed is some consensus between physicians and the public as to what establishes a determination of futility. A patient’s family needs to trust that the physician has the patient’s best interest in mind. The physician needs to realize when enough is enough, and that he/she is not a hero.

There are many complexities that have made the doctor-patient relationship what it is today, but one thing is for certain: you can’t effectively help someone you can’t get along with.

Michael A. Zadeh is a general surgeon and can be reached at Zadeh Surgical, Inc.

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  • soloFP

    How about a doctor who is conscientious, intelligent, and caring? Seeing patients on time and discussing reasonable treatment options are actions that patients expect. It takes years to build up trust between the doctor and patient, but sometimes it is difficult with the out of town family members coming in at the end who did not realize how sick their loved one was.

  • Michael Kirsch, MD

    As far as not being able to treat someone you ‘can’t get along with’, not sure I agree. Sure, it’s tougher, but that’s one of the challenges and responsbilities that we physicians have.

  • Anna

    A doctor builds trust over time. He/she EARNS it. It is not something to which a physician is automatically entitled.

    And, for the record – the erosion of the doctor/patient relationship has nothing to do with health care reform. It’s been devolving for 30 years. I was a very young cancer patient, and have become a middle age cancer patient, with another period of being a young adult cancer patient (yes – Cancer X 3). I have witnessed this erosion from the front line for 35 years.

    The difference in the quality of doctors’ compassion and empathy between then and now is clear. There is a strong sense of entitlement among physicians these days – entitlement to a greater and greater share of the GDP – entitlement to deference and awe – entitlement to the insistence that the world acknowledge that doctors are superior beings, special and that they are the only ones who work hard and sacrifice time with their families to serve a greater purpose. Something went wrong in the med school admission process 30+ years ago and has yet to be fixed. Too many businessmen were admitted – not enough people with a sense of purpose and service.

    • Dr Two Way Street

      Dear Anna,
      Thank you for your comment:
      “the erosion of the doctor/patient relationship has nothing to do with health care reform”.
      I agree with you as I have also witnessed this erosion of the doctor/patient relationship. Here’s my take: the erosion of the doctor/patient relationship has much to do with the hostile & negative attitude patients bring to the office:
      For example:
      -a sense of entitlement from patients thinking the doctor should drop everything s/he is doing with another patient & attend to him/her right NOW. Can you believe that patients actually call a doctor after hours for Viagra on a Sat nite?
      -demanding & rude patients to my staff. There was a time when patients came to the doctors office & were actually consistently nice. To everyone. Even grateful. It’s now uncommon to hear “thank-you” from patients. Sure, I love it when a patient says thank-you to me, but say it to my staff. They work hard & deserve it.
      -disrespectful patients directly to the doctors face. I’ve heard on a number of occasions from different patients, “Well, if something goes wrong, I can always sue you.” Yes, amazing isn’t it. And even if a patient doesn’t say it out loud, you know they very well they could be thinking it. Have you ever heard of how litigatious patients are, yet that doctors win a vast majority of cases? Patients sue doctors, often inappropriately. Now there’s some erosion for you of the doctor/patient relationship.
      -refusing to pay the balance on their bill, even when mailed MULTIPLE bills thru the mail? Even when the doctor did some great treatments for them that preserved their health or even, literally, saved their life. And even sending a patient to collections (the very, very last resort), they still don’t pay. Anna, are we “entitled” when we ask to be paid for our services? Has it occurred to you that most medical school graduates, for many years, have greater than $100,000 in student loans so really need that money to pay them? Is that “entitled” in your book?
      -attitude from a patient when they want the doctor to write some letter for work, an insurance company, school, disability or whatever but expect you to do it for free? These are the same folks that would never dream of being asked to show up for work and not get paid. But they expect the doctor to do it for free. I receive multiple letter requests in any given week. I’m supposed to work several hours a week for free? Do you work for free Anna?
      -haughty & know it all responses when a patient is gently educated that the specific idea they learned from the Internet is illogical & has no basis for fact in modern medicine. And the same response continues when you actually get out the up to date clinical guidelines & show them. Sure, no one wants a know-it-all, abrasive doctor, but really, it took YEARS to become an expert in this field. Some time spent on the internet does not replace those years. Is it possible the doctor is usually right? A vast majority of the time?
      -unrealistic expectations, like when a patient expects a 45 min appointment although only a 20 min was scheduled. And when the doctor says, “let’s continue this conversation next visit” the patient gets rude & angry.

  • buzzkillersmith

    Excellent fifth paragraph. These are indeed qualities that patients appreciate.

  • Ellen Kagan

    Great article. What I think is lacking today – and which is not mentioned much – is the lack of humanity between doctor and patient. This situation goes for much in our society. If doctors and patients treat each other with respect, the rest will follow. Another problem: so many patients think of their doctors as gods. This is a big mistake. They are people – like you and me – with good and bad traits – flaws. So, the patient, once he accepts the person as his/her doctor, should partner with the physician – giving input when necessary. To learn what happened to me with my doctors at a Harvard-teaching hospital – really bizarre, crazy experiences – read on Kindle ELLEN IN MEDICALAND:TRUE STORIES OF HOW I FELL DOWN MEDICINE’S BLACK HOLE AND STILL LIVED AFTER ALL. You will be thinking about my horror stories long after you finish my memoir.

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