What doctors can learn from patients in the health care reform debate

Two things are missing from the bustling conversations on health care reform jamming the Internet highway. First, where among the finger-pointing anecdotes and critical analyses of our “broken” American medical system are the stories and discussions of all that is right? Second, where is our sense of hope?

I’ve experienced American health care from an unusual, yet useful, vantage: that of a physician with chronically recurring cancer. From both sides of the stethoscope, I’ve experienced the challenges physicians face when trying to combine high-tech medicine with old-fashioned caring. And I’ve experienced the challenges patients face when trying to optimize their health (such as after a cancer diagnosis) while living as fully as possible.

Granted, I am biased. With illness forcing me to hang up my white coat in 1993, I have not experienced the full force of the pressures physicians are under today. For me, the opportunity to practice medicine was always an honor and privilege. In addition, as a patient wrestling with a type of cancer with no known cures, I’ve benefited from the progress and hope of clinical research as well as the expertise and kindness of my health care team. Modern medicine has been good to me.

Undeniably, a multitude of forces is driving physicians and patients further and further apart. Sophisticated technologies, increasing specialization, managed care and rising overhead push physicians to see more patients in less time. Our litigious culture encourages physicians to practice defensive medicine. Meanwhile patients face more treatment options and are playing an increasingly greater role in making medical decisions. They are discharged from hospitals earlier than ever, forcing these patients to assume more responsibility in their recoveries.

In our search for solutions to America’s health care crises, let’s pay some attention to all that is right. By dialing down the negative rhetoric, we can learn from stories of patients who are deeply grateful for the care they have been receiving at the hands of dedicated physicians. We also can learn from stories of clinicians who, despite the stress and strain, still derive great joy in patient care. (I suspect the reason we hear relatively few is that most good doctors are too humble—or too busy tending to their patients—to talk about the work they consider a calling, not a job.)

Medicine is an art based on science. Despite all the changes of our modern age increasing the great divide between physicians and patients, healing still begins the moment physicians use word or touch to make contact with patients. And I believe that no matter how clinical practice changes in the future, the heart of medicine will always lie deep within the clinician-patient bond.

Whatever we say or do over the coming months, let’s insist that the physician-patient bond dominates center stage of health care reform. Let’s put a high value on the time it takes clinicians to listen to their patients. By enacting measures that encourage clinicians to provide consistently expert and compassionate patient care, we set the stage for hope for me, for you, and for every American.

Wendy S. Harpham is an internal medicine physician and author of Only 10 Seconds to Care: Help and Hope for Busy Clinicians.

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