Image by EMS Shane in Portland via Flickr
I am writing a series of blog-posts outlining self-care in which we examine the tenets of self-care:
- Introduction to self-care
- self-knowledge
- presence
- moral neutrality
- trust
- patient-doctor relationship/connection (Today’s topic and our final post in this series!)
Self-Care Tip #265 – Use your connections to help yourself and use your self-care to improve your connections (such as your patient-doctor relationship.)
Damaged and premature, my niece was born needing help to live. Now, one year later, I am playing ball with her on the floor. Her intelligent smile, thriving body, and especially the lovely nape of her neck with that baby-curl of hair lipping up makes remembering her near death-dive into life surreal. I don’t want to remember it anyway. But when I can’t help myself, what I like to think of is how my brother and sister-in-law were treated.
The clinicians at UCSD were unbelievable, my brother said. They included him in their decision-making and informed him of medical study results. If you don’t know, if you’ve never been sick or been in a medical setting otherwise, this doesn’t always happen. It isn’t traditional to share medical information directly with patients (such as x-rays, laboratory results, differential diagnoses, and to ask their opinion. Can you imagine?! “…Um. Yes PLEASE! Can I be your patient!?” Sounds like fantasy.)
I’ve also struggled to collaborate. Hovering over charts and laboratory results, many of us practitioners behave as if our patients were at any moment going to throw us into court. It’s embarrassing, even though the truth is, too many of us clinicians are stalked by litigious intentions, whilst the truly awful practitioners seem to sail away on unsinkable malpractice without pursuit.
I have not enjoyed myself when I’ve done this. When I’ve acted suspicious of the very people I’m meant to team up with, work was not good for me. I don’t think my patients felt comfortable with the doctor-patient relationship either during those times. Hearing my brother talk about how he was treated has emboldened me to engage with more trust in the care I offer patients. Moreso, being friendly to myself has helped me be a better physician. It’s tail chasing but with productive and enriching effects.
Making a choice to choose trust and transparency with patients and clinicians, even being present with the fear, is self-care although high pressure. With people’s lives on the line, clinicians and patients know mistakes will happen. The self-care will grow our ability to forgive each other.
My journey with self-care has brought me to see people differently. I look at them from the self-care angle. I look for those sticky bits where we can connect and collaborate. I expect things from them. I ally myself with their self-respect, with their intuitive desire to be friends with themselves. I am bored at work when I don’t do this. I am bored at work when my patients don’t do this too. Without self-care for myself and without my patient’s interest in self-care, medical practice becomes everything that the negative reputations advertise about the physician and the patient.
Yes. My quality of practice has definitely improved.
Who isn’t blessed when she sees the courage to face stigma, shame and bewildering illness? Who isn’t more informed every time someone chooses the freedom to do self-care, chooses to live, fights hard like my niece did and shows what that fight is worth?
Who doesn’t learn from that? When someone loses her identity to the defacing ravages of disease but still knows she is worth the fight, like PattyAnne, working beside her is one of the best places in the world to be. For Me. It starts and ends with Me.
Building trust in a patient or a clinician starts with us staying connected to others in our personal circle and along the ripples as the circle widens. We have to have a voice and hear their voice and we do this by maintaining a community of people.
Connection is part of self-care for both clinician and patient. In the case of PattyAnne, (yes, she’s still in our story,) she could take an action toward her self-care with the intention of gaining stronger connection to her community and to me. She could ask herself about her intentions. In fact, we both would do better self-care approaching each other this way.
Connection via the patient-doctor relationship is self-care and then back the other way too!
It starts and ends with Me.
Questions: Has your patient-doctor relationship been a friendly part of what you’ve given yourself? What are some examples or in what ways have other connections you’ve chosen improved your self-care? How has self-care inversely improved your patient-doctor relationship? Please tell me your story.
Related articles
- Paul Krugman on How to Keep the Doctor-Patient Relationship Sacred: Less Commercialism, More Bureaucratic Oversight (reason.com)
- Re-Humanisation: The Doctor-Patient Relationship (2020health.wordpress.com)
- Prescription meds misuse rampant, deadly: report (cbsnews.com)
- Letters : The Special Doctor-Patient Relationship (nytimes.com)
- Interview of Dr. Dan Siegel about THE MINDFUL THERAPIST (westallen.typepad.com)
In the field of therapy, I was shocked to become aware that in most cases there seems to be very little connection between psychiatrists and psychologists treating the same patient. Even those employed by the same facility. It seems they have a great deal of contempt for each other and my experience is the they do not corroborate when treating the same patient. I had hoped that my experience here was unique but apparently this instances of the two kinds of practitioners “team” treating a patient is what is unique. Certainly the client is short changed.
Thx carl for your frank comment; a style I’ve come to depend on. I need to clarify yours – you’re saying client/patient is short changed cuz therapist isn’t viewed as part of the patient-doc relationship?
I love it when doc take an interest in their patient’s care rather than treating them like a file #. My hubby recently had a physical and had some testing done. His doctor called personally on two occasions to explain results of testing, even the ones that were perfectly normal findings. I was impressed!
yes impressive. that takes a lot of time.
Who doesn’t learn from that? When someone loses her identity to the defacing ravages of disease but still knows she is worth the fight, like PattyAnne, working beside her is one of the best places in the world to be. For Me. It starts and ends with Me….what a beautiful statement! When someone loses her identity….we need more like you Sana!
thank u dear chris. thanks for letting me know we connect and what hit the mark.
I had a doctor who you always had to wait at least an hour to see. She was always behind. The amazing thing is no one complained. Everyone knew that she would take as much time as you needed. After the exam she would sit down and quietly ask how your life was and if there was anything you wanted to talk about.
She would sit with you as long as you needed her. For most it was only a few minutes but sometimes you needed her to listen a bit longer and she always did—she never rushed you.
She has since retired—DANG! The doctor I have now is not quite up to the standard she set–he’s a good doctor but not great.
dang. just when we get good at something we get old and then… retire. (wink.)
I followed my favorite NP to three different practices over the years before settling in with my current OB/GYN provider. I have since branched out to seeing the OBs and other NPs. I followed the first NP because I felt she really knew me and cared about me, and I was willing to switch practices just for that sense of being cared about.
stalker. j/k. i think u gave that NP the best gift of her life. what a girl u r.
Stalker might be right. 😉
awesome!
Throughout the years I have seen a marked improvement on how medical personnel treat patients. Hospitals are emphasizing more and more every year the need to improve patient-medical staff relationship, and it is working.
However, on the Psychiatric Wards things continue to be pretty bad for the most part. The ER personnel do not like individuals who have attempted suicide. I know from personal experience that they treat us without kindness, roughly, and little care to our immediate comfort and needs, and specially they don’t care if the treatment is painful. They send the message loud and clear that they are upset because we are taking time away from other patients, and so on. Also, ambulance personel take the same bad attitude. The really don’t care if you make to the hospital, as I was told last August by one paramedic, with a few chosed words.
It is scary attempting suicide. But I am more worried what the treatment will be like at the ER if I survive. Last night something happened, it was a very bad night and I wanted to blow my head off… except I don’t have a gun. But I just don’t dare ending up in an ER with all those nurses ready to rip me apart. Marie.
Dear Marie, what potentially effective feedback! thank u so much. I am going to share this with my hospital administration and u keep talking. your words will spread. i hope u feel better and am sooo sorry to hear u were hurting. i’m really glad u didn’t harm yourself and am worried that you felt that to cope, you needed to die. keep us posted.
Thanks, I will keep you posted. I do worry that if I ever do die, none of my blogger pals will ever find out, and it will feel abandoning y’all.
Hugs. Marie.
you’re right Marie. u have us standing w u and u r not alone. u r connected to all of us and u r special. tell us how u manage to b your own friend when there are these type of distractors if u r up to it…