Medicine has changed dramatically over the past 50 years. We’ve waxed extreme from a strongly relationship-driven practice to a technologically-advanced and financially-driven system. The time has come for us to bring these extremes together. Only when these two models of practicing medicine are integrated will we truly deliver great healthcare.
When I was a child in Romania, our family doctor made house calls.
I remember to this day, 60 years later, that he was a wonderful old man, with grey hair and big warm hands and kind eyes, and I actually looked forward to his visits. Even at five, I understood at some subliminal level that he was there to take care of me. He would examine me and then more often than not would give me a shot. It was usually penicillin, because fortunately for me I was born after penicillin was discovered.
Surprisingly, I was never scared or afraid of our old house call doctor. After he was done with me, he would sit at the kitchen table with my mother and have a cup of coffee. I have no idea what they chatted about, but it was clear to me they were both comfortable and had a lot in common. He was part of the community, a member of the family, a friend. In fact, he went to weddings and funerals, he was kind of omnipresent in our lives.
Those days are long gone. Medicine has changed a lot.
As it changed, we went from having few or no tools for diagnosing and treating disease, to becoming experts and specialists. And technologically so advanced, we have genetic testing, CT scans and MRIs, blood tests to drown the entire earth in, advanced surgical procedures, radiation and chemotherapy, certainly amazing stuff has been developed. On one hand this is great, and it helps us provide highly advanced care. But on the other hand, in the process, we traded the human touch. This kind of trade is just too extreme. The outcome is a huge canyon, it leads to a terribly dangerous disconnect between the doctor and the patient.
Suddenly, we are faced with a system where the most important person in the system is also the most overlooked — the patient. The patient and the doctor are no longer sitting at the proverbial kitchen table talking, and very few doctors show up at their patient’s weddings and funerals.
In fact, too often the relationship has become adversarial. That just doesn’t work. From where I stand, I honestly and strongly believe this disconnect is one of the primary reasons our health care system is in such shambles. The wrong priorities define the kind of care we provide.
I say to my patients, “I don’t live in your body. I have no way to know what’s going on inside your body, so how can you possibly trust me to know what’s going on inside you. If you honestly start sharing and telling me how you truly feel, I most likely will have a chance at starting to work with you, to better understand you and only together can we try to figure out what’s really going on inside of you.”
Doctors don’t live inside the patient. Unless we communicate and connect really well with each other, we don’t stand a chance to help the patient. And the patient needs to understand that even though I have a highly-regarded and often overvalued M.D. after my name, I am not a mind reader.
To truly help a patient a doctor needs to know so many things: How is his family? His job? What does he eat? Does he sleep? Does he work out? What’s stressing him? How many kids is she’s putting through school?
Honestly, you can get the answers to these questions in three minutes you don’t really need more time. And the answers to these questions certainly put the million-dollar blood, X-rays, CT scans and MRIs along with biopsies into much healthier context.
You don’t always have to give meds, radiate, operate, do a test, you just don’t. More often than not, doing nothing is a lot healthier than attacking and just doing.
You need to learn to stop and listen to the patient, to see the patient like your mother, your sister, your grandmother, just another human being just like you and then come up with a common sense solution for the moment because all we have is just one moment. And if you don’t have any idea what to do. Just empathize. Feel for real. Feel for the patient. They are you. And you know what? As young naïve and idealistic medical students we are experts at feeling. Hold on to that expertise.
Dr. Erika Schwartz is an internationally recognized health and wellness expert and founder of Evolved Science, a personalized medical group with headquarters in New York City and offices in London. She is a New York Times bestselling author whose most recent book, Don’t Let Your Doctor Kill You, was published this month by Post Hill Press.
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