When Doctors Develop a Patient's Point of View

Dr. Robert Klitzman, a psychiatrist in New York City, has written a book called When Doctors Become Patients. It documents his experiences as a doctor suffering from depression, then the experiences of dozens of others.

His point is to show other doctors that when patients complain about symptoms, the doctor needs to really buy-in, not dismiss those symptoms as being overstated.

In other words -- doctor's need to "get it." They need to show some compassion. They need to understand that their patients aren't just blowing smoke.

Truth is, there have been dozens of books written by doctors about their experiences as patients. He joins the ranks of one of my gurus, Dr. Jerome Groopman (How Doctors Think), and others.

So far, way too many doctors aren't getting those messages.

In all honesty, I don't think it's because doctors don't want to understand. Instead, I think the reasons are threefold:

1. First, the system isn't set up for them to have time to be compassionate. Unless they are caring by nature, they don't have time to think about making the right noises for patients to get the impression they care. Even if doctors DO care, they don't have time during appointments to get that message across. That's not their fault -- that's the fault of the system.
2. Second, doctors are human, too. If you had to listen to people complain all day long (afterall -- that's why we all go to the doctor, isn't it?) then you would tend to shield yourself from it, too. Think about it -- day in and day out, year after year, all you hear is complaints. No matter how compassionate you were by nature, that would have to take its toll.
3. Third, it often requires having the experience to understand the experience. Men will never understand the real pain of childbirth. People who have never had a heart attack will ever understand the fear of recognizing that one is having a heart attack. Couch potatoes will never understand the thrill of winning an Olympic medal.

Takeways for Patients:

I think it's unrealistic for patients to expect compassion from their doctors. Would it be nice? Yes, of course it would! But nice or compassionate does not equal good or competent.

On the other hand, we don't want to confuse compassion with the ability to communicate either. The real key is to find a doctor who you trust, and who respects you and communicates well with you.

A nice or compassionate doctor is not necessarily a good communicator -- he's just nice. What we need are the doctors who can help us understand what's going on with our bodies, one who partners with us to make decisions. Those doctors, by their nature usually turn out to be "nice" by our own definitions, too.

A doctor who has been a patient, through difficulties such as Dr. Klitzman's, will be one who develops that ability to be a good communicator and a compassionate doctor, too.

Takeaways for medical schools:

Provide the experience! Of course, male doctors can never truly "get" childbirth, and female doctors will never "get" a diagnosis of prostate cancer -- but there are many ways to role play these types of scenarios. And there are ways to help medical students develop some of that compassion that separates adequate doctors from excellent ones.

The best communicators have the most successes with their patients. Patients who understand are more apt to comply with treatment decisions. Compliance is the number one complaint about patients by doctors.... and teaching communication skills can improve that problem.

So shouldn't this approach be required in any complete medical student's education? It's win-win for both doctors and patients.

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Photo courtesy of PriceGrabber

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