In this high tech age, we are no longer surprised nor insulted by book titles like“Word Perfect for Dummies” or Microsoft Works for Dummies”. In fact, many of us are thrilled to have books that spell out the basics for entry into the mysteries of the computer world.
It seems there’s another area of life that needs a similar primer. It’s a world most of us know very well, the world of the doctor and the patient. There have been galactic leaps forward in medicine in recent years. Amazing new surgical techniques. New treatments for heart attack and stroke victims that minimize potential damage. New drugs for a myriad of diseases. Radiation and chemotherapy advances to fight cancer. Shortened hospital stays. Faster recovery time to restored health. For all of these advances, we are profoundly grateful.
However, there still remains a need to improve the people skills of many doctors practicing today. Comedians like to say, “When will they stop practicing and get it right?” In terms of interpersonal communication, there is less humor and more truth in the question. Certainly, not all physicians are guilty of this problem. (This writer has been very fortunate to have been treated by physicians with the best people skills one could wish for. ) But enough qualify to warrant a refresher book. How about calling it “People Skills for M.D. Dummies” . Do you think it could be a best seller?”
Here are a few first hand accounts: Scene: Wedding Reception. Mother of the groom has big red blisters on her forehead, result of a poorly timed painful eruption of shingles. She’s being a good sport, says she’s “patriotic, red blisters, white glasses and blue eyes.” One of the guests, a doctor, looks at her forehead without an invitation, and pronounces in an offhand manner, “Oh, you have shingles. Some of my patients have pain from that for years.” Thanks a lot for that encouraging information. And, who asked you?
Scene, Office of an Ophthalmologist: Couple in their 80’s having their regular checkup. As the doctor examines the husband, he says, “The left eye doesn’t look too good. You need to make an appointment for a zapping.” Translation, after cataract removals, scars sometimes form. A laser zap usually corrects the problem. In this case, his lead in comment raised anxiety. Then, the doctor asked the wife, “Do you drive?” She answered “Yes”. The couple then worried for two weeks until their next appointment. Zapping went smoothly. His sight was restored to 20/25.
Have you ever been in a hospital when a new doctor, perhaps a resident or an intern, appears at your bedside? He’s holding your chart and says, “Good morning, I’m Dr. X and how are you feeling today, Mary?” Mary is sixty eight years old, holds a Master’s Degree and has three children older than the doctor. Call her Mrs. Evans. She has earned that title of respect with her years.
Or the response to a patient who deals with constant pain, when she related that the new medicine is giving her five or six good hours at the start of the day. Then the pain returns in force. Her neurologist replies, “Don’t look a gift horse in the mouth.” Is that supposed to help her get through the afternoon and the evening?
Finally, an unusual situation with a sighted woman who taught Braille transcription to others to produce books for the blind. During her check up with her opthalmologist, he said in a matter of fact manner, ‘You have a condition where you could wake up blind one day.” As she was reeling from his cool comment, he added, “Well, Mrs. S. You know Braille already.” She came home in an understandable state of shock. She never returned to his office again. And happily, it never happened.
Now, many of us thought the medical schools were giving courses these days in interpersonal relations as well as anatomy and biology. Some of them are. We had hoped that the new generation would learn that human interaction is at the heart of the doctor-patient relationship. We even hoped some of the old dogs would learn some of the new tricks. And some of them have. For the others, here’s a starter list until someone writes the book for M.D. Dummies:
- Each patient is an individual with inherent dignity of being.
- The words you use and how you say them are very powerful. Think before you speak.
- Patients need time to absorb what you are saying. Hearing is not listening. Make sure your instructions are clear. Write them or ask the patient to write them. Ask for questions.
- Take a course in interpersonal relations if this is a new subject for you. They may be available at medical conferences or schools.
- Make sure that everyone who works in your office — receptionist, nurse, assistants take a course or have a seminar in your office for everyone. A patient doesn’t want to meet a “dragon lady’ at the front desk or on the telephone.
- Patients are often worried when they come to your office with a problem. Some are frightened. Never forget that. Your welcome matters. Your smile matters. Your job is to treat the entire person. Not just the rotator cuff or the intestine.
- We know you are usually pressed for time. Try to make each patient feel you are giving them quality time. It doesn’t take many extra minutes. It’s all in the eye contact, the concentration, the personal word. A touch of the hand. Try it. You may like it.
- Stay on top of your field. That’s why patients come to you. But never forget that your main endeavor is to heal the whole human being. How you communicate tells them who you are as well as how they are. That’s the key to the entire equation.
- Rent the movies “The Hospital” 1971 and “The Doctor” 1991. The former with George C. Scott is a sardonic look inside a big city hospital. The latter follows William Hurt, an arrogant surgeon who is diagnosed with throat cancer and learns what it means to be a patient. It was based on the true life story of Dr. Ed Rosenbaum, described in his book , “A Taste of My Own Medicine”. This movie is an education in itself for any doctor.
A final story from the positive side of the ledger. The memory of an obstetrician , a big gentle man who looked like a fullback and instilled confidence in a weary and frightened young woman having her first baby. At the end of sixteen hours of hard labor, when the baby was still not ready to emerge into the world, Dr. S. sat in a chair at her side and calmed her down just by being there. Fifty eight years ago, the father was not allowed to be with the mother through those long hours alone in a white tiled room with an occasional nurse coming in to check “progress”. Dr. S. was there at the end when it was hardest. He gave her something to ease the pain and delivered an 8 pound, 4 ounce son at two in the afternoon. He will always be remembered with gratitude, respect and affection. He was a kind and caring human being as well as a skilled physician. We need more men and women of his caliber in medicine today.
This is a beginning list for the Dummies book. Please add a few ideas of your own. If you are a doctor or a patient, you are probably an expert on the subject.