Most people believe that doctors learn everything they need to know from medical school, internship, and residency.
Those dauntingly thick textbooks sitting on bookshelves in medical offices serve as a constant reminder of the dedication and sacrifice required by anyone heeding the call of medicine as a profession.
While the learning that takes place during medical school and residency is substantial and should never be minimized, the learning that occurs after residency in the clinical environment is equally important.
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I’m talking about what patients teach doctors, in general, and specifically about what my patients have taught me during my years of clinical practice.
I absolutely respect the sanctity of the doctor-patient relationship — it is this special and unique bond that allows doctors to become better doctors, but only if they truly listen to their patients.
I have listened and this is what my patients have taught me over all these years:
1. “One-size-fits-all” medicine doesn’t work. Each patient is a unique human being and medicine must be tailored to meet the unique needs of every individual.
If you practice medicine from a “cookbook,” you’re going to be in the same crowded kitchen with millions of other doctors using the same cookbook; and if there’s a fire in the kitchen — such as a widely prescribed drug later shown to cause death or morbidity — there won’t be enough fire extinguishers on the planet to stop the conflagration. I’ve learned this the hard way — don’t follow the herd. Do your own thinking and your own homework.
2. It’s OK to disagree with your patients, but it’s never OK to belittle them or act in a condescending manner (ie, force them to do things they don’t want to do because you know better).
Most patients come to the doctor with an “agenda” in mind. Ultimately, what they believe is just as important as what is objectively true and verifiable. I’ve learned to work cooperatively with each patient’s belief system. The patient is, more often than not, absolutely right about what is wrong with them.
3. It’s OK to tell patients you don’t know something, and that you can’t make a definitive diagnosis — or that the task at hand is beyond the scope of your practice or your capabilities.
True, patients can be disappointed and frustrated when they come to you to have a certain procedure performed or to get a specific drug and you have to tell them, “No.” Or if they think you can treat them right here, right now, but you have to recommend a higher level of care.
Most patients will respect that you were honest with them and that you took the time to explain why they would be better served elsewhere. Many patients have returned to thank me for the timely counsel I gave them, which turned out to save them much pain and misery in the long run.
