I have been practicing medicine for over a decade now and the other day I got a big shocker. On my desk was a box of dark chocolate truffles in a gift bag with a note that said. “Dear Dr. Mills, I want you to know that I think you are the best doctor in the world.” What? I was dumbfounded. I never did much to help this patient. I checked her blood pressure, listened to her heart, and referred her to a dermatologist and that was it. I didn’t use fancy lasers, perform delicate microsurgery, or do a state of the art facelift to make her look 20 years younger. I didn’t put her on a new medication that could save her life. I double and triple checked the note to make sure that it was intended for me and not the dermatologist I had referred her to for her acne. Had someone prescribed her a mood enhancing medication that inspired this kind gesture?
I couldn’t understand why this patient would remember me months before the holiday season—when patients more commonly send gifts of gratitude. I had really done so little for her, and she had many financial pressures and family obligations in her life. I started to feel guilty about receiving this gift—no matter how small or big it was. I didn’t do anything! I began to get mad at myself for not doing more for her. Then I thought about all the patients whose lives I may have saved who didn’t remember me. I am beginning to realize more and more that what a patient values has very little to do with the type of treatment they receive–or even the outcome of their treatment. It has almost everything to do with the connection.
Medical school introduced me to this whole philosophy early on. We had to take a class on “the patient encounter” in our first year. I remember that I couldn’t sleep all night after taking my first exam. We had actors pretend to be patients and we had to interact with them, get a history, do an exam, and quickly come up with a treatment plan in about 12 minutes. We would be videotaped and the patients would rate us. During my history taking in one of my “patient encounters,” I made the patient cry about how she was depressed and had been abused. She wouldn’t stop crying. My shirt was drenched in my sweat. “Why did I make my test patient cry? I am doomed,” I thought to myself. At my medical school, if you forgot to wash your hands, you would get an automatic fail. I was terrified. I didn’t even have time to formulate a treatment plan because she wouldn’t stop crying. I got my exam results a week later. Supposedly that patient encounter was my highest scoring encounter. My review stated that the patient felt comfortable enough with me to cry and share intimate details about her feelings. That “connection” was what the patient valued on that exam. I hadn’t even offered the patient a solution.
At the risk of sounding cheesy, I am beginning to understand the magnitude of the patient-doctor connection a little better every day. Do you wonder why nearly everyone remembers the name of the Ob-Gyn who delivered their children—the man or woman who handed them the most precious gift they will ever receive in their life? Despite the challenging lifestyle of Ob-Gyns, the emotional rewards of the field arguably surpass those of any other specialty. These doctors are right there next to you on your delivery day and make one of the most emotional days of your whole life possible. They hand you a living breathing human that will change your life, as you know it, forever. Very few doctors can connect with a patient in such a profound way. When I get histories from my patients, I will ask them who did a particular procedure or surgery they have had. More than 50% of the time, PATIENTS DO NOT REMEMBER who removed their gallbladders, their cataracts, or their appendixes. They forget about who did their colonoscopies, mastectomies, prostatectomies, thyroid biopsies, or angioplasties even if it was just a year or two ago and the list goes on. Sometimes, it really disturbs me that a doctor could save these patients’ lives, restore their sight, treat their cancer, successfully remove their brain tumors, or fix their awkward smiles and the patients cannot recall the doctor’s first or last name (and no…my patients do not all have dementia).
But whom do they remember then?
If successful outcomes won’t make them remember you—then what does? The key is: “how do patients feel when they see you and when they leave your office?” The depth of their connection with you is based on emotions–not tangible results. The stronger the emotions patients feel when you see them or leave, the more likely they will remember you (don’t forget the power of the amygdala). They may have felt overwhelming disgust and deep-seated anger–but they will remember you!
Why is all this important? Our medical practices will close one day. We will retire. We will pass away. But–when we are remembered–part of us lives on. The patients who will remember your dedication, your skill, or your expertise are not necessarily the ones you have cured. The patients who will remember you are the ones who felt deep seated emotions when they saw you and when they left your office. They are the ones whom you “moved.” Healing has everything to do with whether your skills and services “move” people and not whether your skills or services “fix” people. Unfortunately, some patients may have had illnesses that were not “fixable.” That doesn’t mean that they didn’t need you or that you were not extraordinarily valuable to them.
The practice of medicine is an art. According to Dr. Bernard Lown, physician and Nobel Prize winner, the art of healing isn’t just about outcomes or science. “It involves engaging patients, listening to patients, caring about patients, investing time with patients, touching patients, using language to inspire hope, and cultivating a relationship of trust with patients.” If practicing medicine were all about technical skill, we would have already built robots to take over the field. If it were all about knowledge, then Google would have already taken over the field. A masterful physician is able to create an impactful “healing experience.” If we can connect with our patients and “move them” enough so that they remember us, then we are inching a little closer to discovering the true art of healing.
Dr. Amy Mills—-Editorial Writer for DoctorCPR.com: America’s #1 Website for Medical Jobs and Practice Resources