Guitars, Bars, and Just a Li'l Good Doctorin'

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Most patients want unhurried, nonjudgmental listening — served up with a generous helping of clinical competence and a healthy dollop of empathy.
Most patients want unhurried, nonjudgmental listening — served up with a generous helping of clinical competence and a healthy dollop of empathy.

One of the most commonly heard complaints about doctors is that we simply don't listen to our patients.

Or we listen, but not very well.

We docs are accused of interrupting our patients far too often — every 18 seconds on average, according to an often-quoted study from 1984 — and of not letting patients have their proper "say."

Some physicians blame their listening shortfall on the corporatization of medicine. They claim that today's volume of patients is too high to allow for much listening.

Doctors are also criticized for spending too much time on computers, reluctant slaves to the relentless demands of the EMR.

Whatever the reason (or excuse), it's a shame doctors don't (or can't) listen more to their patients. Because the stories that patients have to tell are wonderful … if you pull up a chair and show any inclination to listen, any inclination at all.

True, most clinicians only need the patient's history and a physical to be able to devise an appropriate assessment and evidence-based plan.

But even though I am an evidence-based physician, I also think of myself as a bartender in a country-western tavern on a hot, dusty road in Anytown, USA. The patrons are thirsty for human connection.

I can almost hear them say, "Pour me another one of those, Doc."

My patients' stories of life on the road provide enough material for a hundred country music albums … and then some.

(I'm reaching for my guitar, as we speak…strumming a chord or two on my trusty Gibson and softly humming a melody).

Patients want to be heard. They come in for personal validation, to have their say, speak their piece.

If all doctors took more time to listen — really listen — to their patients, my guess is that these patients would require less medication and fewer diagnostic tests.

Pharmaceuticals cannot take the place of listening. Nor can unnecessary, "cover-your-butt" CAT scans, MRIs, exotic labs or referrals to subspecialists.

Doctors who won't or can't take time to listen to their patients are more inclined to practice defensive medicine, which ends up costing everyone more with no improved outcomes to show for it.

Lack of listening also can be misinterpreted by patients as arrogance, and may be what's behind many medical malpractice lawsuits.

If my patients are telling their bartenders more than they are telling me, then I'm not doing my job as their doctor.

Most patients want unhurried, nonjudgmental listening — served up with a generous helping of clinical competence and a healthy dollop of empathy.

Is that so wrong for patients to expect … and for doctors to provide?

 

"Just listen for a minute, Doc,

and I'll tell you a story of broken bones and broken hearts,

of pain radiating everywhere and nowhere all at the same time,

sharp as a dagger,

burns me like a flame,

10 + 1 on any pain scale.

you can name.


I'll tell you of

long nights on the open road,

lonesome and afraid,

with the thought of one special woman,

wedged like a tomahawk

in the pulsating jelly of my brain.

 

Give me your diagnosis.

Better yet, Doc, make it three.

I'll be forever grateful.

Just shoot me more of them pills,

and play your six-string for me."

 

Lyrics written by: Joel Cooper, DO


From the upcoming album, "Real Cowboys Don't Get Toenail Fungus."

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