Bringing Back the Human Side of Medicine - Fixing The Primary Care Crisis

I conducted many interviews of PCPs for this book. Interviewees reported that listening is the key and most important attribute of being a good physician in primary care. They defined listening as being able to focus on a patient's story without rushing him or her, and without embellishing it. They let their patient deliver his or her own story with some prompts to help them focus, but without unduly narrowing the narrative. They all reported that remaining nonjudgmental was a key to developing a strong doctor/patient relationship.

The deputy dean for education at Yale Medical School, Richard Belitsky, M.D., talked to the freshman class a few years ago at their White Coat Ceremony. In part, he told them there was much to learn "but so much of what you need to be really good doctors, you already know... Becoming a great doctor begins not with what you know, but who you are. Being someone's doctor is about a relationship. That relationship is built on trust...Being a great doctor begins not with what you have to say, but your ability to listen."

Samantha told me about her recent medical experience. It was the opposite of what Dr. Belitsky advised the newly minted medical students he addressed: "I've had unsatisfying and frustrating experiences with a doctor lately. Beginning six months ago I've had increasing GI pain and discomfort. Four months ago the pain and discomfort had increased so much I made a doctor's appointment. The doctor entered the room looking bored and gave me the feeling she had something better to do. I was asked a lot of questions and she made a lot of notes but she never talked to me! It was not a conversation...."

You may have had the same experience as Samantha-that's unfortunate but all too common. A primary care doctor must be well versed in medical science but must also carry the traits that define him or her as a physician you can trust and with whom you can have a strong relationship, a provider who likes people and listens deeply to you without being judgmental. And that takes time.



Copyright (c) Stephen C. Schimpff, MD