Dr. Jekyl and Dr. Hyde: opposite types of physician behavior

Today finds 2 related articles about physician behavior, from the crass to the courteous.

An article finds support staff speaking out about how some physicians let big egos get in the way of practicing medicine and spend more time lashing out at nurses than looking after patients. As one interviewee put it, “It is the health care equivalent of road rage.” This diva-ish behavior and snapping at medical staff can create health care issues that trickle down to patients and can cause medical errors. http://www.nytimes.com/2008/12/02/health/02rage.html?em

On the other end of the spectrum, a doctor is promoting simple consideration–manners!–in what he calls “etiquette-based medicine” (a play on the evidence-based medicine that’s touted so much lately). Here’s the NYTimes story that alerted me to his views: http://www.nytimes.com/2008/12/02/health/02etiq.html?ref=health Here’s his original article in the New England Journal of Medicine: http://content.nejm.org/cgi/content/full/358/19/1988

I really like his approach to focusing on the most basic types of kindness and respect. I think being polite could go a long way toward making patients less nervous at the doctor and more likely to come in for treatment. I used to have a great internist who always shook my hand when I came in, referred to me as Miss [last name], and never made me feel rushed. Sadly, she moved to Denver, and the replacement doctor in her office told me “nice to see you again” when we’d never met, treated every question as insignificant, and made me feel like an idiot for coming in with a problem she couldn’t figure out. I’m sure many doctors and patients could benefit from a little etiquette-based medicine!

When doctors become the patients

Armed with their medical degrees and encyclopedic knowledge, doctors can seem invicinble to the patients they treat. But they go through the same trials as normal patients when faced with a frightening diagnosis of their own. In some ways, their extra understanding of health issues can be helpful, but it can cause other problems – they know exactly what’s coming and can’t be placated with vague statistics or “I’m sure things will be fine” reassurances. Here are two stories that really showcase difficulties when doctors find themselves on the other end of the stethoscope:

Dr. Ron Davis serves as the president of the AMA and balances his duties at the national medical association with his treatment for stage 4 pancreatic cancer. He knows pancreatic cancer is one of the deadliest forms, but he tries to maintain an upbeat attitude. “A benefit of being a physician is that I understand what’s happening to me,” he said. “But a disadvantage of being a physician is that I understand what’s happening to me.”
http://www.nytimes.com/2008/09/23/health/23voic.html?ref=health

Dr. Thomas Graboy was at the top of his field when his body started succumbing to Parkinson’s disease. At first he refused to accept the diagnosis, but now he has turned his experience into a tale of surviving devastating changes. The reviewer notes that although Dr. Graboy needed a co-author to help write the book (dementia can be a symptom of Parkinson’s), the finished product retains the doctor’s voice and stands out among other physician memoirs.
http://www.nytimes.com/2008/08/26/health/26books.html?ref=health