This has mostly stemmed from observing the behaviour of my mentor, Dr P - who is an absolute darling with his patients (and to be fair, with everyone around him). During their time whilst under his care, he makes every patient feel - then and there - like they're the most important thing to him in the world. Regardless of how trivial their presenting complaint is, he has no limits on the amount of energy and care he expends on each person individually. As a habitual "eye-roller" myself, this has managed to concurrently kill me and also give me an enormous amount of respect for his ability to sustain such a consistently high level of compassion.
Moreover, however, the cynic in me has started to question the extent of his seemingly endless attention-giving spurges. I mean, he looks after at least 20-30 different people on any given day - and each person is left feeling like, "wow , this person really is genuinely and unconditionally concerned about me and only me!" - so that's a damn lot of people who feel supposedly uniquely loved by their doc. Now, I'll assume that because Dr P is by and large a normal guy, his display of such affections for his patients is mostly just him doing his job very well. So, call me naive in asking this - but does the general public know that it's all really a part of the job?
I don't have my own GP (I just go see the "next available person", who is usually a locum, at my local medical centre when - if - I ever need anything), so thankfully I've never believed that I'm anyone's whole world in a medical context. However, I won't deny that the idea of unrequitted concern and attention by a respectable member of society is very appealing and certainly a trap that I could fall into (now don't y'all start thinking I'm deprived, a-la-Freud), but seriously, you get what I'm saying right? Anyway, my point is - despite the appearance of genuine concern for you and only you - truth is, your doctor "cares about" hundreds of other people and you only have a very minute slice of their love pie. Go find attention elsewhere. *Rolls eyes...*
Okay, that was my random BS post for the week... I told you I have a lot to learn in the domains of compassion and humanity.
***
Onto what I got upto in the town of Mudge. So today, the good Dr P set me up in a consultation room to interview and examine patients on my own; outline DDx, Ix and a Mx plan; before presenting back to him. It was actually a lot of fun despite the fact that I had to shamefully display my lack of talent or abilities to all involved :-S I saw some pretty cool stuff though - people in rural towns get sick too, who woulda thought?! Ha! Then in the evening, Dr P invited me over to his place for dinner with his family which was quite delightful. Which reminds me, can I point out that being a rural GP is by no means the family friendly "life-style" option that I envisioned it to be? Dr P leaves home at about 8am every morning and does not return before 7pm - sometimes later. It's pretty intense because there are only about 10 doctors between his practice and the other medical centre in the area that look after GP consultations during the day and share hospital shifts at other times with additional roles as obs/gyn, anaesthetics and ED physicians. There is a MASS shortage of doctors (especially female doctors, of which there are currently none working in the the medical centre that I'm at) and it takes about a month to make an appointment to see your GP (they have "walk-ins" but you have to wait for hours and you're seen by who-ever is on walk-in duty for that day so there's little in the way of consistency there). Also a lot medical investigations like MRIs and EEGs have to be done in external hospitals with these facilities (usually in Dubbo or Sydney) - which is inevitably frustrating for the patients when these tests are ordered (and I would hazard a guess that most people would be tempted to just not get them done if it means having to travel for a couple of hours out of town). So, yeah, just some interesting thoughts... I'm on-duty in "cas" with Dr P tomorrow - it's a Friday night so it should be interesting, yeah?
"...but does the general public know that it's all really a bit of an act, if I can call it that?"
ReplyDelete"I don't have my own GP ... so thankfully I've never been fooled to believe that I'm anyone's whole world in a medical context."
Sascha, these comments made me feel very sad.
It's not an "act" and no one is being fooled in the sense that no one is trying to deceive another. This is not about deception, but about building an effective relationship.
In any encounter - whether it be with a doctor or a sales assistant - where the person I am dealing with manages to make me feel valued and important, I think "great!". That attention they give there patients/customers/clients is a part of their job, and if they can do it so well as to build trust and a good rapport - they're doing that job very well.
Such suspicion and cynicism about the motives of others makes it sound like you're losing faith in the person sitting next to you. What other happy alternative can you imagine - if the doctor wasn't to make everyone feel special, but everyone feel like a number instead? Or a dollar sign? Or a medical curiosity? Being made to feel special is a pretty wonderful gift, whatever the context!
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Oh no, I didn't mean to imply that an active process of deception was taking place - just that the allusion is often improportional to the reality, which I find to be particularly common in the healthcare arena (as opposed to retail or other vocations). I don't wish for the status quo to change by any means (and it would indeed be a very sad day if it did), it really was just a contemplation on my part. Sorry about the misunderstanding - no offence intended towards anyone doing a great job of making the people around them feel special...
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Ps - I've re-selected my words so as to be a bit more in tune with what I was trying to say.
ReplyDeleteYou know, I am one of those people who is genuinely nice to everyone she meets and really does care whilst I'm talking to them. And I do this indiscriminately, with no judgement, to everyone. Yes, you get my twenty minutes and onto the next person, and I don't see the issue with it - isn't that what you do when you meet people? Be good to them? Make them feel special?
ReplyDeleteThe ones who I develop a lasting friendship with though, are the ones who give the same love back. Obviously in a doctor-patient relationship this isn't possible - they are sick, they require your service, the end. But on a larger scale, as someone who doesn't discriminate between who she makes feel special, I can say that it's the ones who give back that I end up developing lasting relationships with. Most people, I'm sorry to say, will take and take and take the kindness you give them. They will expect to be loved without loving first, they will wait, unsure, for someone to be nice to them first, and that's fine, I will still be good to them, but without a return of the same, there's no way the relationship can move forward.
It comes from a genuine place, and I don't think patients really expect that they are their doctors world, but jeez when you're really sick some kind words make a difference. You don't need them to sit their all day and sing your praises, just take a little time out to explain things and make you feel okay.
In the words of Mark Twain,
"Great people are those who can make others feel that they too can become great".
It sounds like you've scored a pretty special mentor there hun, and a really good one to model off.
Thanks for sharing your thoughts cookbookathon. I really value reading other peoples' insights and perspectives about what I've written. I hope I'm not coming across as cold and callous. Sometimes I'm cynical yeah, but for the most part I'm just trying to sort through my ideas on observations of quite often discreet incidences; chewing through contemplations and possible conclusions that I can draw from them.
ReplyDeleteYou're absolutely right, my mentor is pretty special and I have so much to learn from him and others around me. I envision a day when I can look back on my cynicism and hang my head in shame. I'm working on it. Please don't judge me too harshly for the back-road route I'm taking to get there. I hope that not too many people have to suffer as a consequence either :-S
Regards.
Oh you didn't need to change your post on my account!
ReplyDeleteCookbookathon's comment did make me think about the balance and boundaries you need to find in a doctor patient-relationship you need to find. It's all very well to give yourself indiscriminately, but if people are just going to take and take and take you're dancing with emotional exhaustion.
Audaci wrote a good post recently about her relationship with her GP on rotation at Lismore. I thought it was a good reminder that just as important as it is to make your patients feel comfortable and build trust, it's also important you set clear boundaries and don't compromise your own well-being.
All the best!
Sounds exhausting!
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