Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Real doctoring means mitigating the fear patients have

Hans Duvefelt, MD
Physician
September 24, 2018
112 Shares
Share
Tweet
Share

It’s been said in the world of business that people only buy two things: good feelings and solutions to problems. In medicine, the single most important factor that brings patients through our doors isn’t a “toward” kind of desire, but an “away” one — away from feeling bad.

More specifically, it is pain and fear that most often cause patients to call and ask for an appointment. They hopefully leave with good feelings and solutions to their problems, but that only happens when we have the knowledge, resources and, perhaps most important, the time to give them the relief they seek from us.

I am not considering the purely administrative functions we perform, but even some of them are more “away” desires, like patients needing a work excuse due to illness out of fear of otherwise losing their jobs. Even getting a flu shot or a physical is often rooted in pure fear of illness.

So, how often do we have the knowledge, resources and time to help our patients escape their torments?

And also, forbid the thought, how often is this relief of suffering in the broadest sense the overarching principle that guides each doctor and each healthcare organization?

In my random readings the other night I came across an article, almost a manifesto, by the British National Health Service from 2011. The document was titled “A Better NHS” and I am quoting the part about patients’ pain and the profound responsibility of the treating physician:

The commonest reason for visiting a GP is “fear.”

Fear that the lump is cancer, that the chest pain is another heart attack, the headache a stroke, like the one that tragically disabled Maureen. Fear that I may die before my children grow up, fear that I may lose my sight, my balance or my mind. Fear that I cannot cope, that I am a failure or that I will be judged unfairly and blamed for my suffering. To be a patient is to be unfamiliar with oneself, to inhabit an unfamiliar shell, barely in control and in need of help. The world and our relationships are radically altered when we are patients.

What an extraordinary job we do. Grounded in a therapeutic relationship, everything we do depends on trust. What an extraordinary responsiblity to be charged with caring for people when they are at their most vulnerable and most easily exploited.

Because of this, it is absolutely vital that we are not led into temptation. Just as monks and nuns need to be protected from the distractions of the world so that they can dedicate themselves to God, so we need to be protected from mammon and the perverse incentives of the market-place, so that we can dedicate ourselves to our vocation and our patients, and be the doctor that they need, not the doctor the market makes us.”

This was a call, or a prayer, not to be led into temptation by greed. As employed physicians, which is what most of us primary care physicians now are in the U.S., our temptations to profit from our patients’ fear, misfortune and illness are limited. Here and now, the temptation we all face is maybe not one of the deadly sins, but it is gaining traction:

Distraction from what really matters is perhaps our biggest temptation and a poison we are constantly exposed to. We let our focus wander away from the patient and toward the clock, away from the therapeutic moment and toward the measurable quality indicators. Even when we embark on practice redesigns to become more patient-focused, the certification process itself becomes a distraction from the work we set out to improve.

This week I saw two new patients, both of them with shortness of breath and heart palpitations, both fearful that something was dreadfully wrong. Each one ran over their allotted thirty minutes (my longest appointment type, reserved for new patients and hospital followups) by a good ten minutes, but each one left reassured, one with a clean bill of health, the other with reassurance that only two tests were needed to confirm my clinical assessment that there was nothing serious. Both women gave me a firm handshake, repeated by their largely silent accompanying husbands, both of whom silently mouthed the words “thank you.”

I laid it on fairly thick, I invoked what I sometimes refer to as the source of my calling, and I drew on my experience and they gray hair I have earned recently, and my ability to use simple language and everyday analogies to dispel the mystery of how our bodies work.

Instead of feeling pressured or overwhelmed by these encounters, I felt satisfied and energized. I easily caught up with my schedule and I didn’t give the daily distractions much thought.

I had done some real doctoring. I had mitigated the fears of two fellow human beings.

“A Country Doctor” is a family physician who blogs at A Country Doctor Writes:.

Image credit: Shutterstock.com

Prev

It’s really hard to make money in the stock market

September 24, 2018 Kevin 0
…
Next

Will artificial intelligence ever replace doctors?

September 24, 2018 Kevin 13
…

Tagged as: Primary Care

Post navigation

< Previous Post
It’s really hard to make money in the stock market
Next Post >
Will artificial intelligence ever replace doctors?

More by Hans Duvefelt, MD

  • The art of asking where it hurts

    Hans Duvefelt, MD
  • Thinking like a plumber when adjusting medications

    Hans Duvefelt, MD
  • The American food conspiracy

    Hans Duvefelt, MD

Related Posts

  • Why social media may be causing real emotional harm

    Edwin Leap, MD
  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Physician Suicide Awareness Day: Where are the patients? 

    Jennifer M. Sweeney
  • Is physician shadowing immoral?

    David Penner
  • A love letter to patients

    Marcie Costello

More in Physician

  • Why allowing yourself to embrace discomfort is necessary for personal growth

    Jillian Rigert, MD, DMD
  • Unconventional health care, flawed studies, and biases: Navigating the complexities for optimal well-being

    Kara Wada, MD
  • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

    Zahid Awan, MD
  • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

    Harvey Castro, MD, MBA
  • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

    Marie Livesey, DO
  • Heartwarming stories of cancer patients teaching us about life and the human spirit

    Johnathan Yao, MD, MPH
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nose-brain connection: The surprising link between allergies and mental health revealed

      Kara Wada, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Why allowing yourself to embrace discomfort is necessary for personal growth

      Jillian Rigert, MD, DMD | Physician
    • Unconventional health care, flawed studies, and biases: Navigating the complexities for optimal well-being

      Kara Wada, MD | Physician
    • Urgent innovation needed to address growing mental health crisis among children and families

      Monika Roots, MD | Conditions
    • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

      Cheryl Lazarus | Conditions
    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

      Zahid Awan, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • TAR-200 Led to High Complete Response Rates in BCG-Unresponsive Bladder Cancer
  • More Success for CAR T-Cell Therapy in Rheumatic Disease
  • Nurse Accused of Killing Patients With Insulin; Naturopath Settles False Claims Suit
  • JAK Inhibitor Shows Promise in Severe Type of Sclerosis
  • Adaptive RT Fails to Relieve Dry Mouth in Head and Neck Cancer

Meeting Coverage

  • TAR-200 Led to High Complete Response Rates in BCG-Unresponsive Bladder Cancer
  • More Success for CAR T-Cell Therapy in Rheumatic Disease
  • Trial Shows RA Can Be Stopped at Preclinical Stage
  • Tenapanor Improves Abdominal Symptoms in Patients With IBS-C
  • Benefits Found for Hand OA Drug Treatments
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nose-brain connection: The surprising link between allergies and mental health revealed

      Kara Wada, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Why allowing yourself to embrace discomfort is necessary for personal growth

      Jillian Rigert, MD, DMD | Physician
    • Unconventional health care, flawed studies, and biases: Navigating the complexities for optimal well-being

      Kara Wada, MD | Physician
    • Urgent innovation needed to address growing mental health crisis among children and families

      Monika Roots, MD | Conditions
    • The importance of listening in health care: a mother’s journey advocating for children with chronic Lyme disease

      Cheryl Lazarus | Conditions
    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

      Zahid Awan, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...