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10 Things Your Primary Care Doctor Does That Should Make You Run for the Hills
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Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
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What makes a Physician a Healer?
It is well recognized that physician's relationships with their patients can have healing effects, but not always. What are the core set of healing skills that make a physician a healer? I read with interest a recent study in the Annals of Internal Medicine which studied this question: What are the skills that physicians who have been identified as healers have? The relationship is crucial given that we as physicians probe into our patient's private lives, talk them in to enduring diagnostic tests, and convince them to take new medications that may be inconvenient and painful. What makes those identified as healers different?
After interviews with Expert healers eight skills emerged as pivotal, and I'd like to give my take on them and hear your input: 1) Do the Little Things. This may seem obvious but is as simple as smiling, shaking hands acknowledging others in the room, and making eye contact. Did your physician remember these basic gestures when you met him/her? It is important for setting the tone. 2) Take Time and Listen: Many of you on Dailystrength wonder "will the doctor listen to me?" A physician's willingness to be still and quiet demonstrates there is space to talk. Taking off your coat, sitting down and looking relaxed were noted in this study to be helpful. Listening is the most important thing and letting people tell their story without too many interruptions can help in the healing process. 3) Be Open: The author of this study describes patients who come to their physician visits with their "damaged humanity" from previous experiences. Physicians need to be willing to be open and vulnerable patient after patient. Don't be afraid to shed tears or to say you are not perfect. 4) Find Something to Like, to Love: This manifests most authentically as compassion and understanding. A healing physician will seek in every patient a quality, achievement or mannerism that can be appreciated or admired. Your physician may relate to you as being similar to their spouse, parent, grandparent, and child and that may enable them to feel more empathy. To me this is why I love this job. I love the patients and I think you have to. A nice quote from one of the healers in this study was "You have to be willing to walk the wounded path with them." 5) Remove Barriers: These can be physical barriers (desks, etc) or attitudinal barriers. I try to stress to my residents you are not too good to open a door, roll a patient back in the room, empty a trashcan. Today I was tracking down ice chips for a patient and wiping his runny nose. 6) Let the patient explain: Physicians who are healers are insistent that patients are the best source of information on their condition, obvious to DS members I know. "An essential part of healing is allowing patient's understanding of their illness to be spoken and received" was a comment from this study that I really love. 7) Share Authority: A good physician tries to establish their expectation of shared responsibility for healing at the very beginning. I loved what one of the healers interviewed for this study said "Today's visit is about ascertaining how I can help you. I'll make some recommendations to you but you will always dictate what you want to do." 8) Be Committed and Trustworthy: Patients have a fear of abandonment and will stay connected if they feel you are trustworthy. An intentional plan to sustain the relationship and carry it forward is very helpful. It may be as simple as coming up with a plan which conveys you can count on me, you will always leave with a plan, even if it doesn't work right away we at least have a plan. I write this blog in hopes that I fulfill these 8 "criteria." I feel lucky to have worked with many physicians I felt were healers and would consider the physician who delivered my daughters a healer. I think we should all pay attention to this list and keep it in mind the next time you see your doctor. It is the simple things, they don't take much time. I remember our pediatrics advisor on Dailystrength.org showing me a picture he took of a patient of his at lunch and with the look on his face, I know he loves these kids and loves his job. You can find that. Seek out physicians who are healers because the benefits of mastering skills like these are repaid in many ways which leads to improved patient care. If only I could have all physicians drink the Kool-aid. "The art of healing comes from nature, not from the physician. Therefore the physician must start from nature, with an open mind." Dr O.
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Displaying comments 34-15 of 34
Got a Question?
I was lucky enough to find a great Dr.
My Haematologist set the scene at our first appointment - she saw me as a person not just a disease. During that first interview and examination we discussed all the possibilities (some were pretty scary) and at the end I left her office with something that sustained me for the whole 8 months of Chemo - HOPE
I am in Australia and the hospital is a training hospital .
My Dr's position also makes her responsible for selecting new residents and registrars every few months. She had a knack for selecting those young doctors who had those same positive qualities.
I trusted them all and know they all played a big part in my recovery
Doctors are human beings just like everyone else. We, as patients, are like a customer is to any business. If I would not be rude to my customers then I do not expect my doctors to be rude to me. I understand their backs are against the wall with many issues, but we all have to fight battles in life. Doing it with some empathy and compassion makes it so much easier for everyone involved.
I appreciate you posting this. I thought about what it was that made me like one of my new doctors and many of the things you noted here play a big role. Thank you!
What I miss most about my other GP is how the office was managed. Not just the smiles and respect, in my age it was a given. But they had a system where every call, every report, every prescription was filled before the office closed for the day.
Two days after my doctor received my x-ray report for spots on my lungs I still haven't a call. The receptionist told me he wouldn't call soon, he was busy with patients. Well, I'm a patient *s*! So with that said, I'll take mom's advice to shop around for a doctor, just like anything you do.
Wishing all of you a blessed New Year and a year filled with health and happiness.
James C Chivers PhD. P.E.
I also think having a detective attitude. A willingness to solve the medical mystery that the last 3 physicians missed.
Another quality that would make a physician a healer would be Courage. Courage to take a stand for whats right and in the best interest for the patient. Not always the treatment the HMO believes in.
I used to always take notes for the doctor which I'd give him listing what I wanted to cover. One of the last times I saw my doctor one item on the list was that I was through fighting with them and felt like I needed to bring my cousin who is a criminal defense attorney with me as I always felt like I was on trial for my life.
I had one doctor tell me he realized he wasn't God after missing the fact that I'd been suffering from subclinical hypothyroidism for years. Course, had he done his job, he would have caught it, he just wasn't the brightest light in the sky.
What I look for? Patience is number one. There are some well-educated docs out there, but some are on a power trip. Talk down to patients, not patient, haha, and don't recognize they work with people, not ameba.
I know the doctor is much different but it's the principle. A great doctor listens, validates concerns and addresses the treatment plan as what "we" need to do. The fact that you take the time to come here and try to help us tells me that you are one of those great doctor. Thanks for all you do.
Dr.Orrange, I've never met you, but having read your blog, it's very difficult for me to believe anything other than that you also have the "8." I believe that the desire you demonstrate to serve and heal your patients honors them and you. You, too, raise the bar.
Healing Skills for Medical Practice Larry R. Churchill, PhD, and David Schenck, PhD 18 November 2008 | Volume 149 Issue 10 | Pages 720-724
Also: we dont do 5-7 minute visits in our practices at USC and we all still make a living thank goodness. I agree with you 100% on your last thoughts as well...thanks for the comment!
Dr O.
Do you mind giving the reference html for the list of healers? I would greatly appreciate it.
Also, I think you are probably inundated with clients--the average visit HAS TO BE 5-7 minutes max? For every one doctor, there is ~50 patients and it is predicted to worsen with more patients and less available licensed health care workers... And all of in the field know folks are pursuing ER care rather than healthcare... And what I admire about physicians the most is their level of commitment after years of medical training...
On the opposite side as a research scientist Ph.D., we need to work together to increase technology, information and access to superior health resources and services. When given the chance, I find that EVERY physician I have asked to present "their favorite topics du jour", the layperson response has been incredible--they actually DO learn!!! And they become proactive with their healthcare! I need to do a clinical trial to see if it really makes a significant difference...
Anyhow, I admire your work on this and keep up the great strides...
Peace and blessings,
Dr. G-
You are absolutely right, I experienced exactly the same problem. With Lyme not only are you really ill,
the Doctors basically tell you that its "all in your head"
Doctors forget being good at their job is, all about listening to their patients, and not just assuming that we are trying to get attention. They need Patience, Empathy, Good Listening,clear communication, and the ability to
get to the heart of the problem, without patronizing. We know Doctors are clever individuals, but then some patents want more than just a cold clinical analysis. we want respect.