A Remarkable Doctor Visit: Why Is It So Rare?

A Remarkable Doctor Visit: Why Is It So Rare?

May 9, 2015

I’ve seen many wonderful physicians throughout my life, many for whom I have developed a deep respect and admiration. However, I had an experience a few weeks ago that truly had a profound impact on me—not because of the ease of access, the efficiency of the office, or the most modern technology—but because of the simplicity, humility, and sincerity of the physician.

During the past year, I have been receiving treatment for an autoimmune condition replete with a regimen of daily medications, vitamin supplements, and regular lab tests to monitor my progress.  I was making good improvement and maintained compliance despite some difficult side effects of the medication. My attending physician had an excellent reputation in the field and, based on my research, I believe that my treatment was proper protocol.

At about the one-year point, a test indicated that the inflammation might have reappeared, and my physician wanted me to abruptly return to the previous high dosage of medication.  I had actually been feeling much better overall and was reluctant to go through the debilitating side effects of the meds all over again.  I was at a crossroads and unsure what to do.

I decided to seek a second opinion and, with my physician’s approval, forwarded my medical records to another specialist.  Frankly, I had low expectations; many physicians are reluctant to disagree with their colleagues to maintain professional courtesy.

However, the interaction with this second physician was remarkable and unlike so many others that I had experienced before.

  • First, he took the time to ask many questions and truly listened. He wanted to know what I was experiencing, how I felt, and what if anything had changed. He reviewed my family medical history in great detail, even though it was captured on paper. At the end of the conversation, he probed further, “What else about your medical history might be relevant that we haven’t talked about so far?”
  • He wanted to get to know me as a person. He asked, “Tell me about you.” I glanced at my husband, who had accompanied me, for an answer. “She likes to make things happen,” my husband joked, “and she likes to be the boss.” We all had a good laugh. The physician wanted to know about my profession, what I liked to do for recreation, and what was important to me.
  • He took a holistic view of my health and asked, “What was my diet like?” and “Tell me about your exercise routine.”
  • He shared his own personal philosophy. He explained that his father was a country physician, and he learned to listen and communicate by accompanying his father on house calls. He shared the following quote of Sir William Osler, often called the Father of Modern Medicine: “The good physician treats the disease; the great physician treats the patient who has the disease.”
  • My physical examination was also quite different. He examined me to look for other physical indicators that would suggest a return of the disease, such as taking my blood pressure in both arms and comparing the two. He explained what he was looking for, and his explanations were clear and easily understandable without ‘talking down’ to me.
  • At the end of the visit, he gave me his cell phone # and email address so that I could contact him if I needed to. He ordered some additional tests and said that he would call me the next day as soon as the results were in—and he did.

As a result of that visit and the review of my tests, he said that he did not believe that the inflammation had returned.  While he complimented my previous physician for getting me to this point, he recommended that I reduce the amount of medication, not increase it.  My instincts were confirmed, and I was totally relieved.

I will be seeing the new physician from this point forward. Did I decide this just because he told me what I wanted to hear?  Not really.  It was more because I felt that he took the time to understand me, his communication style was easy and empathetic, and his patient-centered approach felt like a true partnership.  Too often, physicians convey the message that, “I’m the expert; just do as I say” without an adequate understanding of the patient’s true concerns.

What was remarkable about this experience was that this kind of doctor visit is so rare.  I believe that most physicians are well-meaning and truly care about the well-being of their patients. However, they often can’t or don’t take the time to truly listen, and their demeanor makes it difficult to even ask questions.  They sometimes neglect to follow up and are reluctant to provide a cell phone number or email address to reach them personally.  Although well-intentioned, physicians often hurry through appointments due to heavy workloads and fail to engage their patients in a meaningful conversation about their care.

With all the wonderful advances in medical research and technological innovations, I wonder how we can bring this type of patient-centered care back so that it’s the norm and not the rarity. We seem to have moved so far away from Osler’s famous words in the way medicine is practiced.  Are we treating the disease or are we treating the patient with the disease?  I feel very fortunate to have met such a special physician who understands how to put those words into practice.

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