I recently read a post entitled “Patient Satisfaction and Doctor Requests – What’s the Score?” The post addressed the patient perception that doctors are not empathic and the physician perception that patients want to get what they want in order to be happy with their care. The content of the blog post notwithstanding, the phrase “What’s the Score?” is really what stuck with me.
What is the score?
If this is a fight, it is an unfair one with unfair rules. The doctor-patient relationship in its current state is like a marriage fraught with miscommunication, assumptions, and unspoken expectations. And let us not forget third- and fourth-party intruders (including insurance companies and administrators who push for productivity). The encroachment of these groups has put a strain on the original partnership.
One of the reasons I started this blog was to get back to the things about medicine that inspired me during my early years of training. I have had a relatively short career, so I am almost embarrassed to admit that there was a point shortly after residency that I felt I lost the meaning of being a physician. This was a time where I was seeing a large number of patients a day, not to mention all the other non-clinical –but just as crucial- work that was not built into the schedule and some life stressors that were going on at the time. There was no breathing room or bathroom breaks (and I am being literal about the latter, not the former). I believed that I was an empathic and capable physician, but I also knew that my interaction with patients was far from ideal during this time despite my best ability to stay afloat. Luckily, circumstances around scheduling patients changed in my office for unrelated reasons and things improved just enough for me to say to a clinic administrator “I am finally feeling like the doctor I have wanted to be.” Don’t get me wrong. I was still ridiculously busy, but not stressed to the point of physical, mental, and emotional exhaustion.
In some ways, physicians are functioning as skeletons of what they intended to be in our current healthcare system. I was a good example of this. I do not know any doctor who would not prefer to spend more time with their patients and be able to tap into their own empathic side. But the truth is that things like LDL goals, weekly visit numbers, and CPT codes are the measures that are valued because they are tangible and because practicing medicine in this country is still a business, after all, not a charity. So physicians working in cognitive specialties (like primary care) are trying to keep up with demand, working faster and smarter, pushing their neurons to the limits. How is this not going to translate into the interaction with patients?
Receiving sympathy from the general public is not my point here. What would be better is an understanding from both sides. So I cringe at comments and posts that pit doctors against patients. Patients do this. Doctors do this, too. And when doctors make certain negative comments online (mostly anonymously), I find it embarrassing to my profession. But I also know they do not do this out of malice. There is something seriously wrong with a system that turns a bright, well-intentioned, caring, and naively optimistic group into one that finger-points at the very people they aimed to heal.
I unknowingly embarked on a mini-mission to repair the doctor-patient relationship when I started to write this blog. My hope is to educate and inspire and to collaborate with others who have the same goals. As part of this mission, I am also hosting a movie event that is open to the public. It addresses some of the lesser-known aspects of practicing medicine that contribute to a physician’s burnout and will open your eyes to why some well-intentioned doctors are leaving the field.
Remember, what both sides are really lamenting in our current healthcare system is the relationship that they hoped they would have. Ultimately, patients and doctors want the same things. We also both want this “marriage” to work and to have a long-lasting and mutually fulfilling partnership. With the right perspective from both sides and emphasis on the most important aspects of care -not the codes, visit numbers, or provision of unnecessary treatments and evaluations – it can be a win-win for both.