III/15. Doctors
Yield time, but demand professionalism and personal care.
During the cancer diagnosis, prognosis, therapy, and cure, the doctor must judge the patient who depends on the form and directly affects the consequences of those processes. Every doctor is a practicing psychologist and leader of patients who are in an emotional, vulnerable, and uninformed state.
––John Roberts
I will keep pure and holy both my life and my art.
––Hypocrates (c. 460-400 B.C.), Physician’s Oath
Medicine is not merely a science but an art. The character of the physician may act more powerfully upon the patient than the drugs employed.
––Paracelsus, Archidoxies, 1525
Clients don’t care how much you know until they know how much you care.
––Price Waterhouse Coopers TV Ad
Medicine engages life’s existential mysteries: the miraculous moment of birth, the jarring exit at death, the struggle to find meaning in suffering. But medicine is practiced in the mundane world and involves concrete issues like the imbalance of power between physician and patient; the role of quackery, avarice and ego in molding a doctor’s behavior; and the demand for perfection in the face of human fallibility. No insight into its more existential aspects is found in clinical textbooks, properly devoted to physiology, pharmacology and pathology. Rather, it is literature that most vividly grapples with such mysteries, and with the character of physician and patient.
––Jerome Groopman, M.D., “Prescribed Reading,”
The New York Times Book Review, May 13, 2007
Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic.
––Thomas Szasz, The Second Sin, 1974
You will get the most from your doctors if you understand that it is their job to take a serious interest in you, but it is also their job to work within a complicated system, make difficult judgments with or without your help, and take care of scores of patients at the same time. Doctors are well-trained and highly-dedicated professionals who take great care to give attention and avoid mistakes; yet, time is short and misjudgments can be made in a busy and complicated system. There is much judgment in what they do, and they accept that second opinions, questioning, and double checking are appropriate in seeking the best.
Surprisingly, even some doctors have difficulty in handling the patient relationship, the indistinct lines between professional care, human caring, and an appropriate distance in order to preserve their own emotional health. They must deal in rapid succession with many people that they do not know well, people who are emotional, fearful, suffering, and confused, each with a different condition and a different way of dealing with it. Doctors are no different from the rest of the population, in that they have their personalities and foibles, and some are better than others at establishing rapport and a comfortable relationship with every patient. Sometimes, the patient must take the lead, be tolerant, or accept an inadequate response in the time available.
You have responsibilities to your doctor: give respect, maintain self-control, be patient, do your homework, seek and follow advice, be kind to staff, don’t complain except to inform, be cheerful and positive, help in every way. You will be rewarded for being a good patient, a good person, and a good partner.
The doctor is your interface with a highly-complicated, widely diverse, very expensive, time critical, frequently imperfect, and necessarily judgmental medical system. As an MBA with decades of management experience, I am not impressed with the management of our health system or even some doctor’s offices and staff I have observed. As a patient, I have seen a steady series of staff errors, some potentially important, that could have an effect on my well being or longevity. So, I watch carefully, double-check, try hard not to make mistakes, and do what I can to correct them in others. I could write another book on the faults in the system that is trying to save my life, but I remain patient and I try to help those who are trying to help me.
