If there is a central theme to this blog, it is this: medicine is a human thing. On the Facebook page of my podcast, I recently asked for readers to tell me some of the "war stories" they have from the doctor's office. What are some of the bad things doctors do wrong? I quickly followed this with the flip-side, asking readers to comment on the best interactions that they've had with their doctors.
The response was overwhelming, and equally quick to both rant and rave. They told stories about doctors who didn't listen, explain, or even talk with them. They told about arrogance and disconnectedness from the people from whom they were seeking help. They also told about doctors who took extra effort to listen and to reach out in communication. They talked about doctors who genuinely seemed to value them as humans.
I have heard and experienced the other end of the relationship: of both "good patients" and "bad patients." The good patients are the ones who value my skill, interact and listen to what I have to say, and treat me with kindness. The bad ones are the ones who demand beyond what is reasonable. They expect me to jump when they say I should, put down my own personal needs, and perform miracles that I can only wish were possible. This isn't a function of who follows my instructions; I don't consider patients who do what I say without any question as good patients.
The underlying theme is the same on each side of the relationship:
- Patients want doctors who treat them as valued humans.
- Doctors want patients who understand that they are only humans.
Patients want doctors who have empathy for their struggles, who value their perspective, and who respect their privacy. Patients want doctors who understand the patients have lives outside of the doctor's office. They don't want the doctor to treat them as "just a job." The patients are not there to give the doctor something to do; they are there because they need the doctor to meet a need. Patients visit doctors because of the weakness inherent in humans, and they want the doctor to understand, respect, and acknowledge that fact.
Doctors want patients who understand that it is a person sitting across from them in the exam room. We don't have magic wands, we are not the agents of God, we are not brilliant super-computers, and we have lives outside of the doctor's office too. A doctor likes patients who want to share the responsibility of getting well, meaning they are willing to listen to what we say, ask questions, and if they agree with the plan, to follow our suggestions. We also like patients to realize that they are one of many patients they see each day, of hundreds each month, of thousands each year.
Since it's an encounter between two humans, the expectation on either side should be realistic. Doctors and patients are flawed people. Both sides tend to forget this, breeding a lot of frustration in that process.
Doctors forget that patients are sick, tired, depressed, and weak. This means that they may forget things or act out of irrational compulsion. Some patients were traumatized as children, have nasty bosses, or have had bad experiences with previous physicians. Irrational-appearing behavior is usually there for a reason, and that reason is usually not to annoy their doctor.
Patients forget that doctors have bad days, get depressed, are sometimes sick, and can be as irrational as patients. We are forgetful at times, don't always think of things that may be obvious, and even get distracted at times. Sometimes our kids annoy us, sometimes our marriages are bad, some of us have our own past trauma, and sometimes the patient immediately before your appointment was very difficult.
Human, meet human.
If this fact was really appreciated, considered, and accounted-for on each visit, both sides would be much happier. I am not special; I am just a guy who doctors for a job. It is a great job, an honorable job, and a difficult job. But it is just a job. I shouldn't think more of myself than that, and I should always remember that the person I am seeing is just as human. I hope my patients remember this as well.