Uniquely disadvantaged
BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39339.569549.BE (Published 27 September 2007) Cite this as: BMJ 2007;335:630
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I think that the views expressed by Dr Livesey are valid within the
context of those individuals who have had the privelige of being treated
by their colleagues.As a foreign medical graduate, I have experienced the
professional courtesy that was extended to me personally as well as to my
family abroad.This filled me with a sense of vocation, humility and
gratitude.
My experience in the United Kingdom, however has been different.Few
GPs gave the perception of taking any personal or family illness as
seriously as I would have expected. This however varied largely with the
personality of the GP concerned and my own cultural bias.There are times
when I was given the distinct impression that I should know how to deal
with family complaints(though,outside of my area of expertise) and indeed
should have done so, rather than visit a busy surgery. As a medical
student,I was taught that a doctor who treats himself (or family),has a
fool for a patient. This is a motto I stick by.The majority of my patients
are well educated and like them,I visit my GP when I need to.
It is perhaps worth remembering that we were not born doctors and
that like any individual we are not immune to illness. When approached in
a therapeutic capacity by a colleague,we should put our "get over it" and
"school of hard knocks" culture aside and look with compassion at the
patient beyond the stethescope.
Competing interests:
None declared
Competing interests: No competing interests
Double-edge swords: challenges faced by ill physicians
In response to my article on “Pleasing doctors: When it gets in the
way” (1), Mann (2), in highlighting doctors’ limitations, and Livesey (3),
in suggesting the range of struggles sick doctors face, raise important
issues.
In fact, physician illness is a uniquely double-edged sword. Ill
doctors are forced to learn and unlearn much; and face a variety of these
and other complex, inter-connected tensions. They face many challenges
(e.g., stigma, and denial of symptoms), but often now come to see, in ways
they had not before, how they and colleagues can communicate and interact
with patients better. Some alter their own clinical practices, after
seeing, e.g., their own doctors sitting down, rather than standing up when
speaking at the bedside, and framing bad news in ways that still provide
hope and reassurance (even if based not on science, but on a ‘placebo
effect’). Many sick doctors become more aware of the importance of
spirituality and non-medical aspects of care in patient care. The
challenges they face make many more empathetic to the obstacles their
patients, too, confront.
Whether directly or indirectly, these struggles frequently lead
doctors to arrive at insights that can help others. Providers can readily
dismiss patients’ complaints, but the experiences of ill physicians,
having been on both sides of the stethoscope, can potentially be more
poignant and effective in compelling colleagues to improve interactions
with interactions. As I describe, far more fully and detailed, in a book
just published, When Doctors Become Patients (4), the experiences of
wounded healers illuminate multiple critical areas of medicine, and can
inspire physicians – as providers and/or as patients -- to be ever more
effective.
1. Klitzman, R., Pleasing Doctors; when it gets in the way, BMJ 2007
335:514.
2. Mann, H., Why is my doctor too busy to talk to me? BMJ, Rapid
response, 12 Sept. 2007
3. Levesey, A., Uniquely disadvantaged. BMJ 2007; 335:630.
4. Klitzman, R., When doctors become patients. New York and London:
Oxford University Press, 2007.
Competing interests:
None declared
Competing interests: No competing interests