The past two days I have been shadowing a family practice doctor per the requirements of the medical school for completion of the first year, and I was struck with a number of things.
1. I'd like to think of myself as a pretty good communicator, and I don't mean that in a self-aggrandizing kind of way--just ask my fiancee, I'm not always the best at remembering things--but there is something of an art form to medicine. The doctor that I was shadowing absolutely has it down. He know's the "character" that he needs to play during the medical interview process. At times he pretends to be the aloof, almost clown-like character to put people at ease or to get a laugh.
1. I'd like to think of myself as a pretty good communicator, and I don't mean that in a self-aggrandizing kind of way--just ask my fiancee, I'm not always the best at remembering things--but there is something of an art form to medicine. The doctor that I was shadowing absolutely has it down. He know's the "character" that he needs to play during the medical interview process. At times he pretends to be the aloof, almost clown-like character to put people at ease or to get a laugh.
But he also knows that there are times when he has to play the role of counselor, or father, or disciplinarian. There is so much more that goes into medicine than words and formats: he never strictly follows OPQRSTAA (Onset, Provocative/Palliative etc.) when talking about a condition, but he does have his own schpeel that he gives to parents of children under the age of one, e.g. "I like to remind parents to use a lot of sunscreen even if the baby is going to be under an umbrella..."
Moreover, you realize that there are a lot of patients who come in, that he could probably diagnose in a matter of seconds, but still he takes about 5 minutes to talk to the patient about their concerns. For instance, one of the patients who came in clearly was describing a simple pulled muscle, but he still took about 10mins to talk to her about it, before he even began to examine her. Part of it was a desire to rule anything out, but part of it was making sure that the patient felt like she was being heard by someone who cared to listen.
2. The Power of Human Touch. I've heard this a few times throughout medical school but it's important for doctors to touch their patients. Sadly, in this day and age, the first thing that many people would think if you said that was, "Doctor's touching their patients--there should be less of that." Perhaps because of the stigma of the few doctors who touch their patients innappropriately or perhaps due to our Politically Correct/lawsuit happy culture, I fear many doctors may keep their patients at arms length--which is truly sad.
Moreover, you realize that there are a lot of patients who come in, that he could probably diagnose in a matter of seconds, but still he takes about 5 minutes to talk to the patient about their concerns. For instance, one of the patients who came in clearly was describing a simple pulled muscle, but he still took about 10mins to talk to her about it, before he even began to examine her. Part of it was a desire to rule anything out, but part of it was making sure that the patient felt like she was being heard by someone who cared to listen.
2. The Power of Human Touch. I've heard this a few times throughout medical school but it's important for doctors to touch their patients. Sadly, in this day and age, the first thing that many people would think if you said that was, "Doctor's touching their patients--there should be less of that." Perhaps because of the stigma of the few doctors who touch their patients innappropriately or perhaps due to our Politically Correct/lawsuit happy culture, I fear many doctors may keep their patients at arms length--which is truly sad.
Many patients that come off the streets may have been physically abused or mistreated for their whole lives, and the chance to touch someone in a loving way--e.g. rest one's hand on their shoulder, or even hold the stethescope so that one's fingers rest on their back--is often lost.
3. There's so much pain in this world. One of the women who came into the office had been put on large doses of inhaled steroids to treat a very bad asthma attack that she had had. Her face was the slightest bit edematous and perhaps a bit moon shaped (as is common with high glucocorticoids). And a few minutes into their discussion she said, "My face is so fat...I feel like a freak." And she began to cry. My heart just broke for her.
3. There's so much pain in this world. One of the women who came into the office had been put on large doses of inhaled steroids to treat a very bad asthma attack that she had had. Her face was the slightest bit edematous and perhaps a bit moon shaped (as is common with high glucocorticoids). And a few minutes into their discussion she said, "My face is so fat...I feel like a freak." And she began to cry. My heart just broke for her.
Maybe because I could empathize or maybe because it is just human nature, but I couldn't help but well up with emotion for her. I wonder if you need to remember how to respond to the patient, while not letting it affect you. Or maybe you just let it affect you and move on, I don't know.
More to come
More to come
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