On the other side of the stethoscope

May 6, 2005

In dealing with her own health problems, the author learned a lot about empathy and patient service. 2004 DOCTORS' WRITING CONTEST - YOUNG DOCTOR AWARD

As a young physician, I'm constantly learning, making mistakes as I go. Among my recent learning experiences, none have been as instructive as those in which I was on the receiving end of the physician/patient divide.

Soon after my husband and I moved to Colorado, I began experiencing multiple arthralgias and extreme fatigue. What concerned me most, however, was that my lower leg was swollen. My medical odyssey began with a night in the ED (where I had gone because I thought I had a DVT), and continued through a diagnosis of rheumatoid arthritis, periodic flare-ups, two pregnancies, and my first child's hernias.

Because medicine is increasingly a service-oriented field, I'd like to share what I've learned. You might find my suggestions to be little more than commonsensical, but sometimes we need to be reminded that medical treatment isn't the only treatment we can give our patients.

While waiting to be seen by a physician, I overheard a receptionist's argument with her ex-husband. Not only are her problems none of my business, airing them while she's on the job isn't good for your business.

Patients are people, not names on a schedule. The rheumatologist who confirmed that I had rheumatoid arthritis talked with me at length about the diagnosis and developed a detailed treatment plan. Over the next several months I got much better, but at each follow-up appointment this physician scarcely seemed to remember who I was. My medical treatment was always excellent, but the personal element I longed for wasn't there after the first visit.

No one wants to feel that they're simply a name on a list. Briefly review the chart before you enter the exam room. Even though you might not recognize the name, something might spark your memory and help you establish a connection with the patient, making the visit more comfortable for both of you. Few things make me feel worse than when a physician I've seen several times doesn't have a clue who I am. I'd even prefer that the doctor pretend to recognize me.

And if we know that a patient is also a physician, we can act accordingly, especially if we're imparting basic information. For me, this lesson cuts both ways. A few years back, during lectures about the best time of my cycle to conceive, I resisted saying, "I know, I'm a doctor, too," for fear of seeming arrogant. However, I once did a routine male physical, complete with straightforward advice about cholesterol and PSA screening. It wasn't until after the patient left my office, and I glanced at his chart, that I realized he was a physician. I felt like an idiot-which I could have avoided had I scanned the chart sooner.

Attitude is everything. Cockiness is abrasive. Well-founded self-assurance, on the other hand, can be comforting. Our first child was born with large bilateral inguinal hernias. Scarcely a week after his birth we saw a pediatric urologist, who operated on him that day. Although during my training I concluded that some surgeons were too full of themselves for their own-and their patients'-good, I was glad to have this skilled, confident man working on my son.

When it comes to tardiness, mind your manners. Patients understand that you're busy, but it never hurts to apologize for running late. And when a patient has been waiting for some time to see you, give him or her your full attention during the visit.