Compassion. Empathy. These are some of the words commonly thrown around in medical school and residency training. If you ask most medical students why they chose medicine, they will respond with something like this, “ I love to help people.” or “I want to save a life.”
I remembered when I entered medical school, one of my professors said, “In order to be good a doctor, you must be compassionate and have empathy for your patients. You should put yourself in the patient’s shoes so you can better take care of the patient.”
During my emergency medicine residency training, I saw a glaring disparity in how every physician practiced medicine. There is no right or wrong way, just different styles of practice. It is so different that as a resident, I was confused. I keenly observed patient’s responses to different attendings care.
I will hear comments from patients, such as, “ I will never go back to that doctor again.” or “That doctor did not even examine me or spend time with me.” So, what makes a good patient-doctor relationship? Why do patients want to be treated by specific doctors and others despise their doctors?
Let’s talk about some factors that affect how we take care of patient today. Regardless of specialty, the pressure to take care of more patients in less time is at all-time high. We spend less time with patients and more time documenting in our electronic medical records. In emergency medicine, there are metrics, door to disposition, door to doctor time, press ganey scores that are mandated by hospital administration and corporate medical companies.
I get it. It affects us all. But when it boils down to it, the time we spend with patients at the bedside is what matters the most. The emergency department is chaotic, patient’s are in pain, agony, screaming, and sometimes dying. It’s our job to be peace in the middle of the storm.
You see, business people get it. Why do you think Amazon and Apple are two of the best companies in the world? Is because of the products they sell? No. Its their customer service.
In medical school, they do not teach us business strategies but oh, how I wish they did. Because as a customer, what keeps you returning to purchase a product from the same store or brand is because of the customer service experience you had. Why don’t we do the same in medicine?
Medicine is a business. My patient’s do not care what medical school I trained, or residency I completed. They only care how I take care of them. That’s all.
Once I became an attending, I remodeled my practice style using business strategies I learned in business books. I see my patients as paying customers who deserve better services. I see myself as a highly paid servant, as the service of my patients.
This is my routine when I see my patients. I would suggest you try some of these practices.
First and foremost, introduce yourself to everyone in the room, say something along the lines of “ Hello, good morning, my name is Dr. Adesina and I will be your doctor today.”
Next is to give a hand shake to everyone’s in the room, including children.
When you are talking to your patients, don’t forget to address them by their names.
Make it a point to sit down. If there is no chair for you to sit on, sit on the garbage can. Studies have shown that patient’s perception of time is different when physicians sit while talking with the patient than standing.
Take proper history and do a good physical exam, do not take shortcuts. One physician once said, “Do no let the cloth be a barrier between you and the diagnosis. It could be shingles rash causing chest pain, not MI.”
Tell the patient what your plan of action is, and ask if they have any questions. “Mr. X, you came in with abdominal pain today, I think you have a gall stone, I will order some lab tests, an ultrasound of your abdomen and give you some pain meds and return to give you your results.
Return to discuss the lab results and explain the diagnosis in layman’s terms to the patient. And finally, don’t forget to thank them for coming.
Keep a vibrant smile. It affects you and your patient.
So, yes you can be compassionate and have empathy for your patient, but what matters most is how your care is perceived by your patient and that’s what makes the difference.
Dr. Adeleke Adesina
Attending Emergency medicine physician
Methodist Hospital, Houston, Texas