COMPASSION AND DOCTORING

When I think about my health care education several words come to mind. They include:

• science

• anatomy and physiology

• analysis

• pathology

• disease

• diagnosis

• treatment

All of these words were part of an excellent education that taught me the science of health care. They provided basic skills to evaluate TANGIBLE conditions with treatment protocols that followed algorithms usually resulting in satisfactory patient outcomes. We were taught to rely on this education for the definitive ANSWERS designed to solve the problems our patients came to us with.

As the years went by, clinical experience created insight that improved my skills to diagnose the patient often before an exam was even performed. I knew that 50 year old Mrs. “X” who was overweight, sedentary and ate an unhealthy diet complaining of numbness and pain in her feet was likely experiencing diabetic neuropathy (nerve pain.) I knew that 60 year old Mr. “Y” who smoked 2 packs of cigarettes a day for the last 40 years complaining of shortness of breath, a chronic cough and wheezing was likely suffering from Chronic Obstructive Pulmonary Disease. It almost became a game. Even though the diagnosis usually seemed pretty clear, I made sure to follow all the proper protocols to be thorough in my investigation of their problems. After all, this was the definition of being a “good doctor.”

Then one day it happened. The case involved a 15 year old girl who came to my clinic with her father suffering from recurring headaches. After performing a thorough exam I noticed her gait (the way she walked) was off. After taking an x-ray, I discovered an aggressive growth in the girl’s femur (thigh bone.) I referred this girl for an orthopedic consult which lead to surgery two days later. The surgeon told the family the child would have needed a hip replacement (at 15 years of age) if I had not discovered the tumor when I did.

Again, I was very proud of myself for being “that good” and exceeding the standards of typical care. As I was gloating to myself, my staff informed me the girl’s records were being requested for transfer to another doctor’s office. You see, the family called my office (not to thank me for looking beyond their daughter’s complaint of headaches) but rather to have their daughter’s files transferred to another doctor who participated in their insurance plan.

 

How dare they make me feel like I’m just another doctor that can be replaced by any other doctor. How dare they act so unemotionally and treat the matter in such a business minded fashion focused on the financial aspect of insurance reimbursement. I was angry and personally hurt by their response.

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That’s when I began to realize how patient’s felt when I simply “dismissed” them after treating their complaints. “Who’s next?” How relevant were they as people once their “condition” was addressed? These were human beings seen through tunnel vision as nothing more than diagnoses and treatments that generated my income. What about the rest of the person? Did it matter, or would it simply interfere with my ability to see another patient?

This was my  “Ah-ha” moment. It’s not that I was cold hearted, but rather focused on doing (what I believed) was my job. This was the moment I decided to open my eyes and actually SEE MY PATIENTS IN THEIR ENTIRETY AS A WHOLE PERSON. I began to learn how their ATTITUDES affected their BEHAVIOR that affected their HEALTH. I began to learn how to integrate the EMOTIONAL side of people into the health equation. I began to understand, experience and share two emotions with my patients my education excluded from its curriculum; EMPATHY and COMPASSION.

Not only was this not taught in school, it was rarely discussed. We learned the science, but not the humanity. We focused on saving lives without ever thinking to ask the patient, “is this what you want?” We addressed PAIN with various modalities and chemicals, but never thought to address pain by sitting down and talking to our patients about life and their families. This simple act of compassion is more capable of reducing pain and accelerate healing than most doctor’s realize. As I began to see my patients in a whole new light, I was able to help them achieve a better state of BALANCE resulting in a better state of HEALTH. My practice became FUN as I began seeing more and more patient’s smile and appreciate their lives and the quality of health they were achieving. The business side of health care that required so much energy no longer dominated my emotions. I began to learn and see the qualitative benefits even dying patients gained from the time we shared during office visits. You see, besides the clinical responsibilities performed, we discussed LIFE and LIVING.

In retrospect, I never had the chance to thank the parents of that 15 year old girl for inadvertently teaching me one of the most important lessons I learned during my years in practice. I have, however, learned to replace the ANGER I felt toward them with the GRATITUDE I feel today. Not only did this lesson help me become a better doctor, it helped me become a better person.

Tags: attitude, disease, doctor, emotions, ethics, exercise, health, quality of life, solutions