OK, I admit, I AM A DINOSAUR. Why?, you ask. In my own way, I am trying to keep the practice of medicine pure and patient-focused. As many of my patients know and have experienced, I love to teach the medical students at Eastern Virginia Medical School. I also teach the students at the Edward Via School of Osteopathic Medicine in Blacksburg.
During discussions with the medical students, I have found myself explaining to students the lost art of the humanistic facet of medicine. I am passionate about explaining a child’s illness so that the patient and family truly know the issues surrounding the prognosis and treatment of the disease. I love to hug the child so that the child knows that I am their friend. This is ALWAYS the highlight of any encounter. I truly value the trust that you and your child have given me.
Many medical students see this personal touch as uncharacteristic compared to many of their other clinical rotations. One student asked me once “How can I appear to connect to the patient and be compassionate and concerned?” “APPEAR!?”, I exclaimed and questioned. This is not a performance-it is true and valid concern for the patient.
Being a pediatrician, close interaction with the family and child is a central part of the practice. I am privileged to come to know the mother, father, babysitter, teacher, pet, and grandparents. Pediatricians tend to be “part of the family” and I don’t take that relationship lightly. This comes from the fact that I am honored beyond words to take care of children-your life’s MOST IMPORTANT possession.
If a future doctor begins to see their patients as widgets, and not as individuals with complex inner lives, family dynamics and stresses, and with varied spiritual and cultural beliefs, then the students cannot TRULY understand or deal with the patient’s medical symptoms, diagnoses and multiple medications, as well as their own hopes and fears. They will be reduced to APPEARING to be concerned.
Why is this intimate type of medicine disappearing? Today, Doctors are often employed by large group practices, hospitals or insurance companies. It could be argued that it has become easy to become assembly-line providers due to an employer’s expectation of a high profit. At Pediatric Affiliates, we are physician-owned and have only Medical Doctors who can get to know you without external high pressure.
Touch, face-to-face conversation and eye contact are so personal and all are central in the relationship of a caring doctor and a trusting patient. This is the time-honored way to codify the doctor-patient relationship. At a time when technology is ubiquitous during medical training, I believe that the electronic health record has done the most to distance doctors and patients in the last century. Have you noticed doctors that do not look at you as you are telling them your concerns? Have you noticed that hospital nurses spend more time documenting in the computer instead of being at the patient’s bedside?
So how else has medicine become more impersonal? When I graduated medical school, there was no “hospitalist” (a doctor who takes care of patients only in the hospital). Nurse Practitioners and Physician Assistants now see many patients instead of a Medical Doctor. Nurse triage phone lines are established to have a nurse (who may not know you) answer medical questions instead of your being able to speak with a physician on call. Phone trees that keep you on hold when you have a concern about your child seem to be everywhere. Specialists, who are so backed up with appointments, can be extremely difficult for your child to see in a timely manner. There are the denials by insurance companies that leave a doctor to help the parents fight a claim instead of the doctor seeing patients.
I guess I just long for the “old days” when there was some cohesiveness between all of the fractured centers of medical care for a child. It seems to me that communication between doctors used to be instantaneous and collegial and due to this, patients were taken care of in a more humanistic way. I have nothing against technology as long as it solidifies a strong doctor-patient relationship. So, if it seems that I do things a little old fashioned, I hope you will see beyond that to the benefits that you have as patients.