|The doctor will see you now|
Sanders laughed about how doctors seem to run all the tests themselves on “House.” “Do you know what would happen if I tried to run an MRI machine?” she asked.Sanders is a clinical educator in primary care at Yale University and writes a weekly column for the New York Times on medical diagnosis. We should all be so lucky as to have a doctor like Sanders, who believes in the power of story and who apparently takes the time to listen to patients in her clinical practice.
The process by which a disease diagnosis is made is a linchpin of medicine. It often goes unnoticed and undescribed, yet is arguably the most difficult and most important thing doctors do. While physical exams and tests also figure in, patients would have better outcomes, Sanders said, if their doctors took the time—usually no more than an extra minute—to really listen to what they have to say.I don’t think this advice should be limited to primary care docs. I’ve seen specialists who act as though they’re clairvoyant, and are untroubled by whatever symptoms I’m eager to describe but about which they can’t be bothered to hear. The assumption is that blood tests and/or imaging exams will tell them what they think they need to know. Genuine conversation is pointless.
Sanders made the point that once a doctor has heard a patient’s story and arrived at a diagnosis, that he or she should play the story back to the patient as they understand it. It’s an interesting proposition—and is totally unlike what most of us experience. Sanders has the research to show that this playback loop improves care through faster healing, less pain and better patient adherence to treatment regimens.She didn’t say it quite so bluntly, so I will: Patients need to be heard. They deserve to be respected. They appreciate being partners in their care, as much as that is possible. And they don’t want their doctors to demonstrate House-like sociopathic tendencies. Some of us would gladly trade a little less medical genius for a little more attention.
Sir William Osler, the 19th century physician who has been called the father of modern medicine, was once quoted as saying: "Listen to the patient. He is telling you the diagnosis." Sanders is eager to remind us of that truth. And I will pass along the same message here. Patients should be encouraged to tell their stories. This intrusion of more humanity into medicine would be a good thing and could end up making us all a little healthier.