Paul Curran does not have a blog per se, but he has guest posted all over the place including at Cordelia’s Mom Still and Willowdot’s and Doobster’s (don’t click the link to Doobster… it will just depress you). He also comments a lot over at Gibber’s place. This man knows an awful lot about an awful lot of stuff. In fact, he is pretty much an expert when it comes to healthcare because he has had to live it, through some very difficult times.
I say all of that to lead up to the questions he asked me on the It’s All An Act post:
Do you think medical school prepares a doctor sufficiently for seeing the big picture – the quality of life of the patient – or do they over-emphasize the technical side of practice? As you can tell from the question, my personal experience is that the medical profession spends too much time on the disease or organ and too little on the patient. How do you feel about that statement? Do you find it a common concern?
I agree that there are a fair number of physicians who lack the ability to empathize with their patients. This is probably on par with any other profession but in medicine you feel lack of it more acutely. When a patient is hurting and frightened and confused, more than anything they want someone who can show some degree of compassion.
Why is this so hard for some physicians?
Sometimes it is an issue of survival. Critical care specialists? They are machines. Not very personable. But if I were the one dying, I want that physician on my side even if they are not giving me warm hugs. If you allow yourself to feel everything, you will soon lose yourself to it all.
Sometimes, the subject matter precludes it. Nephrologists? Numbers. All they care about is numbers. And they are crazy smart, too. But take an astrophysicist and put them in the midst a group of religious fanatics and someone is going to go crazy. Or die. The two cannot coexist.
Often it is a time issue. In the rush of a busy day it can be hard to slow down and take the time to find that place of empathy. Sometimes it hits me later, long after that patient has left my office, when I have time to process everything. This is one of the reasons why divorce rates are so high among physicians. The job is fast paced and demanding and overwhelming and at the end of the day there has not been enough time to even consider your partner’s needs, much less fullfill them. Patients get lost in that, too.
How do you fix it?
Some will probably disagree with me, but I am not really sure that empathy can be taught. Certain people are born with the ability to place themselves in someone else’s shoes. Some people stumble upon it, often because of finding themselves living through something awful. Others have to be taught how to fake it.
The market rewards empathy. When I refer patients to specialists, I want someone who first knows their stuff, but secondly someone that the patient will like. I try to match personalities if I can. Not everyone wants a physician who holds their hand. Doing it like that makes me look good. Managing up the other physician doesn’t hurt, either. “This neurologist is just the best there is!” But getting patients in to someone personable is often not possible… those physicians are too busy. High demand. When we have to settle on someone else, I will often tell patients about that physician’s personality… knowing what they are getting into often helps.
What do you all think?