Most Patients Don’t Want to See Me

I’m the only person in my immediate family who works in the medical profession. And when I visited with my extended family last weekend, I was reminded of how much they dislike even thinking about medicine. My older relatives have reached their 70s with relatively few health problems and only see doctors when absolutely necessary. To them, doctors take up valuable time, poke and prod them in uncomfortable ways, and (worst of all) have the potential to deliver bad news. My relatives don’t understand why I would want to do those sorts of things all day long.

It’s good for me to get their perspective every now and then. Maybe most people don’t want to come see me, and I guess that’s reasonable. Even if I feel that I have something important to offer—prevention, diagnosis, treatment—someone who feels pretty healthy may not be interested in finding out about any new problems. Dr. Robert Lamberts, another physician blogger, recently wrote about his assumption that most patients do not want to be in his office and how it helps him to be more compassionate toward them and give them better care.

But I don’t believe that most physicians think much about this. Look at it from our standpoint: We have a list of patients in the morning—some familiar names, some unfamiliar—and we think about the way our day will go. Maybe we’re a little tired, or unhappy about something in our lives. It’s hard to look at that list and think, Ninety percent of these people don’t want to see me today! Instead, the thinking goes: All right, maybe we’ll make this one feel better, or maybe that person has a problem we can solve. Or maybe we can’t do much for this person, but we can lend a sympathetic ear.

In my field—kidney disease—the dialysis unit is a surprising exception to this. Patients on dialysis have to come in three times a week. As physicians, we typically see them once weekly for a brief visit during dialysis. These interactions are among the most positive I have with patients. We talk about how things are going and make small adjustments, and I listen to any problems they’re having. I come to know these patients quite well, and they get to know me (some even tell me they miss me when I’m on vacation). Although they don’t like dialysis, it has become a fact of life for many of them, and the visits with physicians (and nurses, dietitians, or social workers) become a positive aspect of that life.

But I know those patients may be the exception to the rule, and I’ll try to remember the perspective of my relatives when I meet with my other patients. What is routine and comfortable to me—the job I do everyday—is a foreign and sometimes scary aberration to their routine. Going to a doctor’s office is a detour from somewhere else they’d much rather be.

(PHOTO: CORBIS)