Cooperation between patient and doctor is essential today in health care

There are many aspects to being a doctor. Just as important are the many aspects that go into being a patient. Of course, the difference is that one has been perceived as being a position of power and the other one has not. I don’t believe this distinction is useful or true in today’s world.

Patients and doctors work together, more and more, to get the job done, so to speak. Such cooperation is an essential part of today’s health care world. It is nearly as important as two newlyweds learning to live together and deal with each other’s foibles and idiosyncrasies. Well, almost.

Doctors and patients are of course simply two different groups of people with similar goals – to find out what is wrong and fix it in a timely fashion. One group – doctors, and let’s include all other health care personnel too – have areas of expertise that allow them to focus their efforts on delving into symptoms and signs of illness to find the diagnosis. Patients have their areas of expertise too – they know themselves and what is wrong with them. Of course, some people know themselves better than others do, and that makes the doctors’ jobs that much more interesting and useful.

The more doctors and patients work together, the more patients will feel that they are a part of their care. The truth of the matter is that doctors can get caught up in so many details of a day of medical sleuthing, or the bureaucracy that surrounds Medicine, that they forget to focus on the patient in front of them. This lack of direct attention leaves people/patients feeling that doctors don’t care. Or they feel that doctors are too busy to take enough time to adequately discuss their issues. There are many criticisms of doctors and most of them at one time or another are quite valid. Each of us, unfortunately, can get too busy to pay attention to proper details. The goal is to try to keep such failings to a minimum so really big mistakes don’t happen.

Dr. Donald Berwick recently gave a beautiful graduation speech to his daughter’s Yale medical school class. In his speech, he describes an unfortunate couple who were separated by a policy which precluded the wife from visiting the ailing husband while he was in the ICU. Someone somewhere thought it would be smarter or safer if the spouse/family member of an ailing person doesn’t spend too much time in the ICU room with their loved one, the patient. His aim in describing the anecdote was to inspire the graduates into realizing that we are all patients. Each of us, doctor and patient, needs to take a look into the mirror each day and pay attention to the type of image we deliver to the world. Then focus on each person in front of you. Make him/her know that you care.

Presumptions are made as we go along happily caring for people. Some of us, like me, call everyone by their surname – e.g. Mr Jones or Mrs Smith. Other people use first names. I have read that both are appropriate. But how do you know who likes to be called Bill and who prefers Mr Johnson? Out of respect I use the surname unless or until someone asks me to call them by their first name. I hope that’s the right choice. But the point isn’t whether I have made the correct choice. The aim is to adhere to what the patient wants. If I use the first or last name for someone who wishes the opposite, I am doing him/her a disservice. If I do it again, after correction, I am being disrespectful and ignorant.

And, as Dr. Berwick said in his speech: “Those who suffer need you to be something more than a doctor; they need you to be a healer.” These are powerful words and he isn’t implying that each doctor needs to be an encyclopedia of medical knowledge. He expands his comment by telling us, as doctors, to “do something even more difficult than putting your white coat on. You must take your white coat off. You must recover, embrace, and treasure the memory of your shared, frail humanity – of the dignity in each and every soul.”

Treat people with respect, admiration and dignity. That, I think, is the secret of a great doctor – something I aspire to be everyday.

Paul Dorio is an interventional radiologist who blogs at his self-titled site, Paul J Dorio, MD.

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  • Susan

    What a beautiful post. I along with many people would welcome that kind of relationship with our doctor/healer. And sometimes, just like with married couples, there are difficult discussions to be had. But with a good relationship as the foundation, questions like these don’t need to be difficult to discuss between doctor and patient:

  • Alice

    And, as Dr. Berwick said in his speech: “Those who suffer need you to be something more than a doctor; they need you to be a healer.” [end quote]

    Nice job! The Director asked me a few weeks ago, “What do you think makes a good doctor?” My answer reflected your own thoughts. You get it! I shared that often a patient’s heart conquers their mind……and even if all specialists there were of the same competency a great one can hear a patient’s heart. It takes something medical school often can’t teach…..because it is a silent cry……..but if you listen closely and look beyond the outward wound and open your heart…… hear it… respond….and like metaphorical heart surgery…….a connection of healing is created. He agreed.

    Our surgeon would sit down next to me when he had to share something he knew I didn’t want to hear. You could see his eyes changed…….he would search for words and he would find them. He would come over and take your hand and force you to look up from your stare at the floor….you looked into his eyes……. and then he would encourage you with a soft voice. I can’t express in words what it meant that he took the extra 60 seconds to speak to each of us. My daughter just posted on Facebook that he is the most wonderful, kind, caring doctor she has ever met and what his leaving meant to her. That he is not just a great surgeon………he is an empathetic doctor who helped us, possibly, on the same level as his scalpel.

  • Jackie Fox

    Lovely post. This is such a special bond and it seems to be fraying due to so many outside pressures, but we can make it work one encounter at a time. You summed it it up perfectly when you said treat each person with respect, admiration and dignity. I agree that makes for a great doctor and I am blessed to have been under the care of a great family doctor, general surgeon, oncologist and plastic surgeon for breast cancer. All of them understood there’s a person attached to the breast.

    The only thing I would add is that it’s a two-way street and patients would be mindful to treat doctors the same way. Some people come down so hard on the empowerment side of things that I think doctors are made to feel like the hired help.

    Thank you for this great post.

    Jackie Fox
    Author, “From Zero to Mastectomy: What I Learned And You Need to Know About Stage 0 Breast Cancer”

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