What I learned while I was ill

Feeling better and back at work, I have had some reflections about the process that encouraged me to make changes in the way I approach my patients-more than 25 years into practice.

First, I was scared. No matter that I knew what was going on and knew how safe most everything was; there were moments when I thought I was not going to make it. Fear trumped knowledge, panic bested data.

Second, I did not want a lot of information. At a time when our patients continue to challenge us with the latest entries from the internet, I found myself relatively uninterested in what was going on, what options were available, how decisions were being made.

Instead, I found myself in a much more primal position: "I'm broken. Fix me so I can go home." I'm still willing to give my patients all the information they want, but if Mr. Browne says, "You take care of it, Doc-do what you need to do," I'm now more willing to do so.

Third, I was not very impressed with competence. As a referring physician, it has always been important for me to send my patients to competent colleagues, but this really wasn't much of an issue for me as a patient.

I expected everyone to be competent and to do their job, just as I expect the airline pilot to get me to Detroit and the Verizon representative to transfer my contact numbers to my new phone. Of course they know how to do their job-it's their job. I'm now finding that while I expect competence when I make a referral, my patients and I are entitled to more-more courtesy, punctuality, empathy, and respect. I'm now less likely to say, "He has a poor bedside manner, but he's very good at what he does." Now I want a good bedside manner too.

Finally, of all the physicians and healthcare providers I encountered, who are the ones I most remember and think most positively about? Not the ones with the starring roles, such as the surgeon, who did a great job, and not the ones with the most skill, such as the nurse who started a painless IV.

No, it's the ones who were caring, the ones who made eye contact with me and smiled, the ones who asked me how I was doing, the ones who assured me that everything was going to be OK. I guess that's what Mrs. Carter means when she brings me cookies and tells me that "My other doctors are fine, but you are my nicest doctor."

So avoid getting sick if you can, but feel free to use the lessons of my illness:

1. Deal with fear. Your patients may be afraid, even if you see no reason for them to be.

2. Give your patients only the information they want. Some simply want you to do what is best for them, without extensive explanations.

3. Expect more than competence from your colleagues. Require them to treat your patients, your staff-and you-professionally and respectfully.

4. And perhaps most of all, be kind to your patients. It is not always the most highly skilled physician who has the most impact; it often is the nicest one.

Richard E. Waltman, MD, is a family practitioner in Tacoma, Washington. Send your feedback to meletters@advanstar.com
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