REFLECT

Model stories written by young professionals/students.

 

The Degree of Desensitization

 

 

Historically, physician training has not entailed a great deal of sensitivity training. This lack of adequate sensitivity training has played a crucial role in the formation of the stereotypical callous and cold physician. In today’s medical school physicians are often trained to put blinders in place and focus all of their attention on the diagnosis, speed the appointments up, in order to see a greater quantity of patients. The problem with this, ignoring the obvious emotional damage done to the patient, is that sometimes there is more to making a correct diagnosis than just the ‘medical’ symptoms presented. There is more to treatment than just medication. 

Most quantity minded physicians do indeed see more patients in less time but in order to do this they must make certain sacrifices. Perhaps the most blatant sacrifice is not taking the time needed to really get a holistic view of the patient’s malady while affording them the respect they deserve. By limiting the amount of face-to-face doctor-patient interaction time there are crucial symptoms or circumstances surrounding the patient’s complaint that the doctor could easily miss. It is important that going forward medical culture must attempt to learn from mistakes made and find a middle ground between quantity and quality. It is a balancing act, but a necessary one in order to restore these doctor-patient relationships.

I spent some time this week shadowing in a clinic. I was observing a program designed to guide pregnant women with substance abuse addictions through their pregnancy by providing them with anti-addiction drug prescriptions, prenatal care, and therapy sessions. This clinic was run quite differently than other medical private practices that I have shadowed at. The care was entirely team based, with two teams; each composed of an OBGYN, two nurses, a translator if necessary, and two social workers. Because of the extremely high-risk nature of the pregnancy the social workers played an essential role in the treatment plan.

I found it fascinating when one patient told me that they actually enjoyed meeting with the social worker each week and attending the group therapy sessions. She only saw her physician for a few minutes each visit; never long enough to form any sort of connection. She said that when she was talking with her counselor she felt like she actually mattered and she could tell that the counselor had a genuine interest in her well-being. This sort of interaction between social worker and patient was observed several times throughout my visits to the clinic.

One social worker in particular went well above and beyond the call of duty. With every patient she asked the required questions, but then she took it one step farther. She inquired about their feelings and any problems they might have had since their last visit. Because her sincerity was obvious the patients opened up and were brutally honest. They told of their problems, where they were living and who they were been living with. Some even honestly told her that they had suffered a relapse. Rather than condemning the women, no judgment was passed by this social worker. She immediately presented the women with their options and did everything within her power to ensure they got the assistance they needed.

If these patients were only receiving care from a physician the existence of these problems might be overlooked, while they only receive treatment for their addiction or pregnancy. This inability to view the entire picture and make an unbiased diagnosis derives from the desensitization of the physicians. After seeing trends and patterns of patients presenting what appears to be the same condition on a daily basis it is easy to see how one might start to form a bias and lose their objectivity. The physicians start to lose their ability to empathize with their patients.

Effective communication about sensitive issues, without losing sight of addressing the diagnosis itself will aid in the rendering of a more thorough and accurate diagnosis. I think it is important to note the effectiveness of the social worker’s sensitivity and compassion. Many nations across the world are striving to improve doctor’s bedside manner and lifestyle training. Empathetic care is key to the patient’s compliance and successful recovery. Perhaps, if doctors went through a short training similar in nature to that of the social worker, they might be more adept at handling these sensitive issues and adopt a more holistic approach to their medical practices. 

-LL Byrd