Checkpoint

Dr. Richard Dew | Grief | Compassion | Bedside Manner
close up of patient and doctor taking notes

1. PATIENTS DESERVE RESPECT

Patients are the sole reason for our existence. They are the ones for whom we spend years learning to care.

Society recognizes their importance as citizens when it establishes standards of training before we can be licensed to treat them. Our government recognizes their importance through Medicare, Medicaid, and the myriad government-sponsored health programs.

Patients should be important to us as individuals. They are not interesting diagnostic puzzles to be solved. Neither are they merely broken nor flawed mechanisms to be mended or fixed. True, they do need to be diagnosed and treated. But they are living breathing people who deserve to be understood and respected.

2. WITHOUT PATIENTS WE ARE OUT OF WORK

Patients are the ultimate source of our livelihood. This was much more apparent in the days before insurance, HMOs, and prepaid medical care. This is likely to re-emerge in the near future as more and more patients become in essence self-insured and begin to shop and compare fees—and attitudes— among doctors. We expect to receive good quality service at restaurants, in our schools, from entertainers, mechanics, builders and anyone else who charges us for their services. We cease to patronize those who demonstrate their lack of appreciation by indifferent or surly service. Patients feel the same about us. We are being paid well for our services. It is incumbent upon us to be sure that patients, at the very minimum, get their money’s worth for the care we render.

3. TREATING PATIENTS IS A PRIVILEGE, NOT A RIGHT

A third thing that escapes many physicians is, that no matter how highly skilled we may be, patients are doing us a great favor by allowing us to treat them, not vice versa.

It is of paramount importance to remember this during our training. Medical students and residents are extremely bright and intelligent. However, in all honesty, if you, your wife or your child becomes seriously ill, are you going to have the top student in your class, or even the chief resident, care for them? I think not. In our training, many of the patients we treat have no choice who their physician will be. We are their doctors because they are on the teaching service and have nowhere else to go. They are allowing us to learn medicine on them. In a sense, they are our guinea pigs. We owe them big time.
When we are asked to see patients in consultation, they have little choice. They see whom their doctors tell them to see.

Similarly, with the rapid proliferation of hospitalist programs, many of our patients don’t choose us. They are either referred to us by their private physicians who do not admit to the hospital, or they are simply assigned to us from the emergency room. It is easy to forget that here, also, the patients are doing us a favor by allowing us to treat them. We are beholden primarily to them, the patients, not to the referring physician, the hospital or whatever group might employ us.