Six Lessons on Medicine You Can Learn From Your Patients
A physician shares the top six lessons he has learned from his patients.
Most people believe that doctors learn everything they need to know from medical school, internship, and residency.
Those dauntingly thick textbooks sitting on bookshelves in medical offices serve as a constant reminder of the dedication and sacrifice required by anyone heeding the call of medicine as a profession.
While the learning that takes place during medical school and residency is substantial and should never be minimized, the learning that occurs after residency in the clinical environment is equally important.
I'm talking about what patients teach doctors, in general, and specifically about what my patients have taught me during my years of clinical practice.
I absolutely respect the sanctity of the doctor-patient relationship — it is this special and unique bond that allows doctors to become better doctors, but only if they truly listen to their patients.
I have listened and this is what my patients have taught me over all these years:
1. “One-size-fits-all” medicine doesn't work. Each patient is a unique human being and medicine must be tailored to meet the unique needs of every individual.
If you practice medicine from a "cookbook," you're going to be in the same crowded kitchen with millions of other doctors using the same cookbook; and if there's a fire in the kitchen — such as a widely prescribed drug later shown to cause death or morbidity — there won't be enough fire extinguishers on the planet to stop the conflagration. I've learned this the hard way — don't follow the herd. Do your own thinking and your own homework.
2. It's OK to disagree with your patients, but it's never OK to belittle them or act in a condescending manner (ie, force them to do things they don't want to do because you know better).
Most patients come to the doctor with an "agenda" in mind. Ultimately, what they believe is just as important as what is objectively true and verifiable. I've learned to work cooperatively with each patient's belief system. The patient is, more often than not, absolutely right about what is wrong with them.
3. It's OK to tell patients you don't know something, and that you can't make a definitive diagnosis — or that the task at hand is beyond the scope of your practice or your capabilities.
True, patients can be disappointed and frustrated when they come to you to have a certain procedure performed or to get a specific drug and you have to tell them, "No." Or if they think you can treat them right here, right now, but you have to recommend a higher level of care.
Most patients will respect that you were honest with them and that you took the time to explain why they would be better served elsewhere. Many patients have returned to thank me for the timely counsel I gave them, which turned out to save them much pain and misery in the long run.
4. The "chief complaint" given at check-in can change dramatically before check-out. Patients are not always comfortable discussing the intimate details of their lives and bodies with staff members who see them before I do. I can certainly appreciate and respect this.
If you are too focused on the "chief complaint," you may miss or gloss over the real reason for the visit. Patients will lead you to the problem and correct diagnosis — but again, listening is essential.
5. Patients remember things you may not always remember, such as how you treated them in the past or how you helped them feel better when they were feeling badly. So much of what doctors do is on "autopilot." We're trained to take care of people and that's what we do. And we do it over and over again, multiple times a day, nearly every day. But a patient will remember if you took the time to care about them.
6. Not all patients will be doctors, but eventually, all doctors will be patients. Experiencing the other side of the equation — even, if only occasionally, as the patient — has made me much more compassionate and empathetic toward my patients.
Doctors are scary to many patients. After all, doctors worked on and dissected corpses in medical school, and have seen blood, guts, and gore aplenty. They deal daily with urine, stool, and sputum samples, and have touched, felt, and appreciated all kinds of disease – from simple strep throat to the patient in the throes of death.
Doctors can even elicit fear in other trained medical professionals. By signing on as a patient, you are, in effect, making yourself even more vulnerable. You're taking off the mask, stripping down to your skivvies, and trusting the doctor to do what's in your best interest.
My patients have taught me to be less scary. I sit down and talk with each of them; not in a heavy-handed or domineering way. I stay down to earth, and even make fun of big medical words like "idiopathic."
I try to make my patients laugh whenever possible. And I try to make them see that despite my white coat and badge labeling me as "physician," I really am no different than they are — I've just had a few more years in school, perhaps, but I'm still very much a student of the human condition. I realize there are many things about life and medicine that I will always be hard-pressed to fathom.
But at the end of the day, I can rest assured that despite my relative ignorance, my patients will teach me everything I need to know.