[tweetmeme source=”Healthmessaging” only_single=false]I had a WOW experience yesterday when I accompanied my wife to interview a new doctor for her. As some reader may know she is being seen by specialists At MD Anderson Medical Center in Houston for Stage IV lung cancer. She has not had a local oncologist for the past 6 years…but she does now. And we both love this guy!
You need to understand that I have been very underwhelmed by the local oncologists I had met up till now. I am sure they were clinically proficient…but as a group not a one could muster a smile….or any sense of interest or curiosity in my wife’s medical condition. I held out little hope that this new doctor would be any different.
After being ushered into the exam room, a Physician’s Assistant came into the room to get smart about my wife’s history and records (which she brought). Three things surprised me about the PA. 1) She was incredibly thorough actually reading the radiology reports and reflecting with my wife on what she learned, 2) her empathy – as she read the reports she actually used terms like “bummer” when she read how my wife developed pneumonia during her treatment, and 3) she faithfully summarized the results of her review to the doctor before he came in. In other words – the PA listened and heard what my wife shared with her!
Now enters the doctor. He has a warm smile on his face while he extends a hand to my wife and me. He says just enough for us to know that he has talked to the PA. He asks my wife to sit on the exam table and does a physical exam (also a rare event these days).
He then got her down from the exam table into a chair and sat down himself facing us. He asked my wife why she was there and what she wanted to accomplish. After all she had world class docs back in Houston. He asked her why she thought her docs in Texas had stopped her oral chemo for 3 months. He asked why they suggested she start some of her care locally instead of continuing to go down to Texas. If the point isn’t obvious…the doctor seemed to value her opinion of what was going on with her care.
He empathized about it is like to be treated in a world class academic medical center….often long on experience but sometimes short on bedside manner. He volunteered that given my wife’s situation he saw his role as collaborator with her primary cancer care team in Houston. He would take care of her needs locally and advocate on her behalf when needed with the “experts” at MD Anderson. And I was worried that this guy’s nose would be out of joint given her continued relationship with her docs in Houston. The visit ended with a hug between my wife and her new doctor. Something my wife told the doctor she was used to from one of her Houston docs.
What we like about my wife’s new doctor is his “mindfulness.”
Specifically we liked the doctor’s attentiveness, curiosity, flexibility, and presence – all qualities of mindfulness according to note researcher Ronald Epstein, PhD.
We have already established the doctor’s attentiveness to the details of my wife condition. His curiosity was evident by his questioning of my wife’s opinions on how her case was being managed. In addition, the doctor enjoyed working with lung cancer patients. The doctor flexibility was evident from his willingness to play “second fiddle” to my wife’s doctors in Houston. Finally this doctor was “present” at all times during her visit. He listened, picked up on “cues” from my wife and I, anticipated my wife’s needs and never looked at his watch.
So the next time you visit your doctor…or you visit with a patient, you might think about “mindfulness.”
It doesn’t take any more time I suspect…but can make all the difference to patients and their caregivers. Heck I was so impressed that I wrote a blog posting about it!
Sources:
Epstein RM. Making communication research matter : What do patients notice , what do patients want , and what do patients need ? Journal of General Internal Medicine. 2006;60:272-278.
Mind The Gap 
Great Post asking Docotrs to be human,real and transparent to their patients and act like they give a darn about them as people…..what a concept
Maybe we can get a consultant to incorporate the concept into a sigma something or another and tweet it out to everyone and like the idea on facebook
Kerry,
Thanks. FYI.. as the doctor left the office I acknowledged his great “bedside manner” and he replied that “of course I empathetic with my patients.” I had to ask him (jokingly of course) how that was possible given physicians’ proverbial 1) lack of time and 2) they didn’t get paid extra to be empathetic…lol.
Steve
This raises conflicting emotions in me. How wonderful that your wife has found an oncologist with such a high level of ‘mindedness ‘ and willingness to partner with her. On the other hand, how frustrating (and sad) that an oncologist behaving this way should stand out so strongly from the pack. I work at an NCCN hospital and struggle with these issues daily. How do we support the creation and advancement of oncologists who are the “best” in the clinical or research arena and who will (can?) take the time to listen and truly engage with their patients? What are the key factors that produce this type of practitioner? Is it individual personality traits, training methodologies in medical schools, hospital culture, scheduling practices?
Patients may have some impact by exercising their right to choose another doctor or hospital, but when dealing with life-threatening illness, how do you not opt for the “best” physician, hospital, treatment, etc. even if mindfulness and empathy are lacking?
How do we convince the hirers and promoters at the “best” places that these qualities should be one of the priorities when choosing physicians?
I just found your site and I am very impressed by and interested in your area of focus. As a physician, I do believe there is a gap in what and how we deliver (that has nothing to do with how knowledgeable we are) and what the patient is really looking for and I appreciate stories on successful empathic interactions between doctor and patient. Keep up the good work.
Omada
First, I can hear the relief in your voice that you and your wife have found an oncologist you feel will partner with you. What this physician is demonstrating is a role shift that does not take more time or money. Instead of what most physicians have been taught- to tell you the answer- he is working collaboratively with your wife, respecting her wisdom- to get good outcomes. This is a different mindset- a more collaborative strategy- and it can be learned. Best wishes to you and your wife
I am a cancer patient being treated at a hospital in Los Angeles. I don’t want to be too much of a cynic, but am curious if this new doctor knew about your background in medical reporting. Maybe resulting in a little VIP attentiveness. I wish I could relate to your experience, but I honestly can’t. Although I’m confident about my care, I always feel rushed, with the doctor’s hand on the doorknob after a few minutes into the appointment.
Emily,
Haha. My wife tells me to keep my mouth shut about what I do. Believe me I fear her more that the doctor!
Emily you often only get one chance to “get it right” when it comes to treating cancer. If you have questions or concerns you owe it to yourself to ask whether you feel you are an imposition or not. Just smile and say…hold on there…I have one more question…they will get the point…after all it’s your life and your health! 🙂
This is an incredible article! I am a medical student, and I have had the same experiences looking for a good doctor (just a GP, not a specialist). I’m writing with what is hopefully some encouraging news. The school I go to, Western University, makes us take mandatory Communications courses throughout our schooling. We attend lectures, watch videos, and have simulated client experiences that we are graded on. The latter involves the school hiring actors to come and play the patients, and they/we are given a scenario (e.g. having to tell them a diagnosis, or they tell us symptoms that they’re concerned about). The point is not to correctly diagnose the patient, nor is it to choose the correct tests for the patient (that is what our other classes are for), rather to practice the tools for building a trusting, caring doctor-patient relationship and getting that “great experience” that you talk about.
I have to be honest, I came into these classes thinking I wouldn’t learn much because I am already good at building relationships and being empathetic (or at least I think so!), but I have learned a lot from these classes. I also thought that a class could not change whether or not you’re a good communicator, or if you will be able to have great relationships with your clients, but based on what I have seen, I think it definitely helps some people, and as I said, it helped me too!
Its unfortunate that not all students, and not all healthcare workers have to go through these classes, but I wanted to at least put the word out that some medical schools are trying to do something about the client-doctor relationship!
Best of luck to you and your wife!