Patients need more than just pills, IV lines, and surgeries. So often do we forget that patients are people. We start dealing with them as diseases or clinical vignettes. Instead of Mr. Smith we say “the 40 year old diabetic male in room X” or something along those lines. A scene from the movie Patch Adams comes to mind. During rounds while the case of the patient is being discussed Robin Williams interrupts to ask what the patient’s name is. Surprisingly no one answers because no one knows. We have too many patients and too many diseases. What we make ourselves know is what bed the patient is in and what he or she has. We neglect the rest. Sure we ask about some personal information in the patient’s history, but if it’s irrelevant to the case then we forget that too. There’s too much information for us to know so we drop what we think is the least important: a patient’s name and personal information regarding him or her. The reasoning behind this isn’t wrong. If you forget a patient’s name they won’t die because of it. They also won’t live just because you remembered it. On the other hand if you forget a patient has uncontrolled hypertension then you’re making a fatal mistake.
We fail to realize, however; that these things make a difference to patients. A patient feels better when his or her doctor is also a friend and not just some random stranger in a white coat who checks in every few hours to ask a few questions and look at some labs. You need to establish a bond with your patients whether it’s at the hospital or in your office. That’s why nurses are so special. They manage to create a bond with patients regardless of how busy they are.
Nurses are like the glue that brings everything together. They’re always busy, and yet they always make time for patients. They know their names and understand their needs. A nurse will know the names of every single patient on his or her watch. They’re also likely to be on a friendly basis with patients. They take the time to know about a patient’s life, family, and other things about them. They also manage to be advocates for them. Patients are sometimes intimidated by doctors which especially happens if a doctor is the kind we already described who really keeps their distance. So when a patient is presented by a choice and senses that the doctor is inclined to one of the choices he or she may just go with that option. Not always because they trust their doctor and their judgment, but because they’re afraid and don’t want to go against what the doctor wants.
To be clear we’re not talking about doctors influencing a patient’s decision and taking control of it, it’s just that naturally as professionals, doctors may have a preference for one of the options and unintentionally that preference is clear to the patient. A nurse may understand that a patient is scared and that they don’t really want to proceed with that kind of plan and will let the doctor know. The doctor of course will then have a calm and understanding discussion with the patient to make things clearer and reevaluate the choices together.
Nurses are also in contact with patients more than doctors. If a patient is in discomfort or in pain they’re going to tell one of the nurses. They may even be saying it in a joking manner thinking it’s not something relevant medically that should be reported. It could end up being something significant that wouldn’t have been revealed to the medical team unless the nurse was friendly with the patient.
Establishing a strong relationship and bond with your patients will have plenty of rewards for you as a doctor. First of all just like in a clinical scenario we start with history taking. If a patient trusts you and sees you as a friendly person then they’re going to reveal everything to you while you’re taking history. If they feel like you’re judging them or that you’re in a hurry to go do something else then they may skip parts that might end up being relevant or important. When it comes to treatment plan having a patient’s trust can make all the difference in the world. If you’re a surgeon and your patient trusts you then they’re not going to opt to NOT have the surgery. Instead, having full faith in you and that you’re going to do your best for them they’re going to go ahead with as little fear as possible. If you’re prescribing a treatment plan for them they’ll definitely follow it strictly if the doctor patient relationship between the two of you is a strong one. If it’s not so strong then they might neglect some of your instructions and this happens a lot.
Morale is very important in medicine. The saying “mind over body” is true to a certain extent. It’s why placebos work and people get better despite not receiving actual treatment. Knowing that they’re supported by their doctor patients can get much better. If you have a patient admitted to the hospital who has no family or friends, do you think medication will be enough to make them recover? Wouldn’t it be infinitely better to feel like they have a friend in their doctor?
Unfortunately doctors usually have too much going on to have enough time for patients. You could be seeing plenty of patients a day, leaving on vacation or to attend a conference, or hurrying to finally spend some time with your family. At the end of each day you need to remember why you’re doing this: to help people who need it. Forget your student loans a little. Don’t let your obsession of repaying that debt overshadow your ability to help people. If you’re seeing 15 patients a day and barely have time for anything else than cut back and only see 10 patients a day. What’s better: seeing 15 patients a day for 10-15 minutes or seeing 10 patients a day for 20-30 minutes? Not spending enough time with patients due to a busy schedule may cost you as you end up making mistakes due to the hastiness.
If you work in a hospital it won’t hurt you to spend 5 minutes every now and then with a patient. Talk to them and get to know them a little. Put a smile on their face. They’re already scared and in a hospital. To you the hospital is your 2nd home and considering how much time you spend there it may even be your 1st home, but to them it’s a scary and lonely place. Doing these things will make you feel better; seeing that you’re actually making lives better rather than simply treating diseases and pathologies. Eventually the happiness you get from doing this may be enough to protect you from depression and burnout which are things so many physicians suffer from right now.
Yes it’s true that doctors have so much on their plate, but so do nurses. So why should they be the only ones to establish bonds with patients? It’s a duty that should be shared by everyone involved in healthcare. At least know the names of everyone in the ward or ICU and a few things about them. Joke with them and cheer them up. They’ll feel better in ways you can’t assess through lab reports, but in ways that will reflect positively on their health. This will also reflect on how you feel and make you much more satisfied with your job and performance. Always remember that you’re dealing with and treating people and not just diseases.