Juggling a variety of prescription doses, patient allergies, and surgical techniques can be tough for any doctor to handle, but one aspect of the job that has no clear-cut answer is the delicate balance he or she must toe between treating the patient as a patient, or as a friend.
If you asked 10 patients and 10 doctors to describe their ideal doctor-patient relationship, you’d likely get 20 different answers. Some people want a professional doctor who is only focused on curing their ailment; others want a more personal doctor who will walk them through every step of their procedure and speak to them in terms they will understand. In a perfect world, you could have both, but doctors are usually tasked with helping many other patients, so it’s imperative they find a balance between comforting a patient and working swiftly.
The Art of Detachment
During their training, doctors are taught the “clinical” approach to patient care. That mindset keeps the doctor calm under pressure, and removes emotions that would mentally and physically drain a person throughout the course of the day. As Sir William Osler, the father of modern medicine once said, “A rare and precious gift is the art of detachment.”
Detachment is essential for some doctors, but for others it can actually work against them. If you’re a doctor in a severe trauma ward, it may be best to detach yourself from developing an emotional connection with a victim, because the rate of mortality is often higher than most in this section. Seeing death on a daily basis is no easy task, even more so if you felt a connection with the victim, but there is still no area in the medical community for absolute detachment. If a patient passes away, the doctor will still need to express empathy to the family in order lessen the impact of the death of a loved one.
Clinical studies have even found data that supports the notion that a balance must be struck. Research has found that doctors who act in too perfunctory of a manner; speaking in a language over the patients’ head or assuming they understand everything that was said, can actually have a negative impact on clinical outcomes.
Finding a Balance
Walking the line is no easy task, but some areas of practice lend themselves to being able to connect with a patient on a more intimate level. Take a foot and ankle surgeon, for example. Although they are still tasked with managing many patients on a daily basis, the best surgeons take time to connect with their patients to help calm their fears about an upcoming operation, or a lengthy rehab.
Some people will say “Well that’s easy for foot surgeons, they aren’t dealing with life and death on a daily basis.” In a sense, that is true, but in another, that couldn’t be further from the truth. For the patients they operate on, it is their life that hangs in the balance. Maybe not in the sense that their heart will stop beating if their condition isn’t fixed, but for the high school athlete trying to get healthy for his senior year, or the grandma who wants to be able to go for walks with her grandchild, the operations that are preformed do deal with life and death; the potential death of one’s former self, or the possibility to return to their pre-injury life.
Dr. Silverman comments
I spend more time developing relationships with my patients because I know that is what is expected of me. In turn, I demand more from my patients, because the relationship needs to be two-fold in order to succeed.
My relationship with the patient starts well before they ever go under the knife. I work on their pre-op diet, ensuring they receive the proper vitamins, minerals and nutrients. For some, I challenge their obesity or weight issues; others I delve into diabetes care and how to manage the disease; and for many I discuss proper exercise and stretching techniques.
I am there for my patients for anything they want to talk about. I am their doctor and I am a friend. It will take longer, but building the relationship is essential. I get better results with patients who feel like they would disappoint me, their friend, the doctor, if their rehab failed. Accountability to more than oneself is key. I put my heart and soul into their soles. They can see that, and they give me back the same respect.
Related source: Medscape