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What Makes a "Good Doctor": Patients' Viewpoint
As I teach first and second year medical students. Is there one quality in the performance of being a physician that I should stress to the students is the most important in being a good doctor? I mean, one quality which sets the definition of a good doctor. In answering my question, I look to the perspective of the patient interacting with their physician and what the patient is really looking for to give the doctor the title "good".. However, which would also be most interesting would be to read opinions of those visitors to my blog who are or were patients themselves who have interacted with doctors as to what single quality they are looking for which makes that doctor "good" and should be part of the education of my medical students to attain. What should I teach them?
..Maurice..
7 Comments:
Maurice,
I will fire the first shot on your question:
A GOOD physician is one who TRUELY (and Not just lip service) puts the WHOLE patient (mind, body, soul, spirit, DIGNITY) FIRST, and above ALL else (including policies, guidelines, traditions).
My explanation is simple, like the golden rule. Not only does it involve earning (and keeping) the patient's trust, understanding that certain screenings/procedures have psychological harms, knowing and admitting one's limitations (i.e. despite 30 years of practicing, Doc Google will have more complete and up-to-date information than most humans), asking the patient (NOT telling), practicing humility (physicians may know the body better than anybody, but the patient knows their body better than any physician), and (most importantly) following the patient's wishes even when the physician feels uncomfortable or not being thorough (example: DNR).
-- Banterings
Banterings, thanks for your starting of this discussion. You didn't mention anything about a "cure" of the patient's illness. Does "cure" have anything to do with acclaiming a doctor a "good doctor"? ..Maurice.
Maurice,
Is curing the disease NOT part of putting the patient first?
There is a new series on CBS called "Bull," in Season 1, Episode 6: Bedside Manner (you can watch it here), Bull faces a surgeon with a big ego and a God complex who is being sued for malpractice.
SPOILER: The surgeon says that he has the skills to do complex surgery but not to offer condolences when things go wrong. The relevance of this is that the surgeon caused emotional harm and damaged the reputation of the profession.
Let me compare this to Victorian and Edwardian orphanages: children are clothed, fed, and sheltered, but are they not emotionally injured?
A cure without compassion and dignity is not a cure. Curing disease is mostly skill. Doesn't all that testing ensure skill?
The hardest part is diagnosis, and that is just as much art as it is science.
There is a minimal amount of proficiency in the technical aspects of medicine that is expected.
-- Banterings
I agree. There is more to the profession of medicine than a "cure". Doing the work as a physician isn't the same as a plumber called into the house to fix a leaking sink. ..Maurice.
once again KevinMD is publishing articles about medicine written by students with minimal clinical experience. Frankly if medicine were loaded with more emphasis on public health statistics I would have picked something else to do. That does not mean I am diminishing the importance of being able to review data, clinically evaluate methods and assumptions and analyze published material. Medical knowledge and technology has exploded in the last decade however academic leaders call for shorter years in med school and residency training .Those interested in population health and public health and research will seek out those electives pertaining to their chosen fields of study. Five years post residency training lets poll the authors and see if they feel the same way they do now.
Faruk, I presume you are a physician and have experienced the certain degree of the strenuous life, perhaps even somewhat "down and dirty", that envelops medical students after graduation where the goal focuses on the attending, treating and hopefully curing each individual patient while others are still waiting for the doctor to attend to them and where the concern about the overall public health seem far away and to be managed by others. It may well be for those "others" who are currently interested in public health to develop a system so that the average physician in practice will have the time and interest to aid them in the quest for better and wider applicable public health. ..Maurice.
Maurice,
I beg to differ with you (and not disparage either profession) about a plumber and a physician. Both are VERY much alike. Both require special education and apprenticeship (although one takes more money and time than the other). Most of what both deal with is the routine: clogged sink, remove the trap, ear infection, acetaminophen and corticosteroids (if fluid behind the eardrum).
The average person may be able to take care of most problems by going to a a Walgreens or Home Depot. If you ned a regulated substance like an antibiotic for an infection or refrigerant for your central air, you need a licensed professional. Some people have appointments with both even when there is no problem; preventative maintenance to "check things out."
There are instances when something happens that is so complicated, we need to call these professionals like replacing a furnace or surgery.
(No offense Maurice,) even with your education and experience, do you think that you could install, wire up, charge (refrigerant), test, and tune a central air/central heating system?
Both have also been known to take advantage of their clients and abuses have occurred. Both use to be owned by the professional who had great autonomy, but are now being bought up by corporations. Both are highly regulated (building inspectors, licensing, etc.) and have standardized protocols (National Fire Protection Association [NFPA] "fire" code).
One could even say: There is more to the profession of plumbing than a "tightening of a loose pipe". Doing the work as a plumber isn't the same as a physician called into suture a simple laceration...
If one truly knows the History of Plumbing, you would know that clean water and sanitation has had just as big an effect on public health (a topic Faruk brings up) as modern medicine (if not a greater effect).
Should plumbers be offended at your original statement? How many other physicians would share the same sentiment (without really thinking about the analogy)?
Again, I am not saying that you made the statement with any malice, and there are differences between the professions, but my point is that there are many more similarities.
I also think that this course of thinking should also stimulate critical thinking on the topic: "What Makes a "Good Doctor"...
-- Banterings
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