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Catherine Calderwood: champion of “realistic medicine”

BMJ 2016; 355 doi: (Published 11 October 2016) Cite this as: BMJ 2016;355:i5455

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Re: Catherine Calderwood: champion of “realistic medicine”

Also, I would like a doctor who is not only a talented physician, but a bit of a metaphysician, too. Someone who can treat body and soul. Anatole Broyard

Realistic medicine needs to be laminated by empathy, warmth, and genuineness. Being “heard and accepted” - like communion - goes beyond an intellectual understanding of the patient's need and mind. It makes it necessary to develop a relationship that links the patient, at a minimum through the doctor-patient relationship, allowing the physician to think like the patient. It will develop a connexion-nexus between the patient-physician. A transpersonal relationship between the patient and physician will be the first dimension to be established before we start treating the patient. It may appear utopian when the physician in some countries do not even have the luxury of that human touch that creates trust due to the number of patients they see per day.

Some of the barriers listed for communication between the patient and physician are as follows
*Foreign language spoken
* Dysphonia
* Time constraints on physician or patient
* Unavailability of physician or patient to meet face-to-face
* Illness
* Altered mental state
* Medication effects
* Cerebral-vascular event
* Psychologic or emotional distress
* Gender differences
* Racial or cultural differences

It is suggested to overcome these barriers a physician may need to 1. know what the patient already knows, 2. what the patient needs to know, 3.Be slow, 4. be empathic, 5. anticipate reaction, 6. tell the truth, 7. study the body language of the patient, 8. keep it simple, 9. be hopeful.

Choice of words, information depth, pattern of speech, body position, and facial expression (body language) can greatly influence the patient-physician relationship. These learned behaviors along with what we define as realistic medicine can pave the way for a therapeutic model that may meet the needs of the patient and well-being.

Competing interests: No competing interests

12 October 2016
Dhastagir Sheriff
Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research