What Ails Doctors (Part I)
“Patients get about 18 seconds to tell a doctor their concerns before being interrupted,” Richard Frankel tells me. Frankel is a professor of medicine and geriatrics at the Indiana University School of Medicine, and he has studied the amount of time allotted to a patient’s complaints.
As the author of “Four Habits of Highly Effective Clinicians,” Frankel is also trying to do something about these shortcomings. If you think your doctor isn’t dealing with what ails you, Frankel knows why.
Not only will you likely be short-shifted by medical professionals in terms of time, he adds, you will also encounter other problems. Many doctors, for instance, are unwilling to discuss a terminal diagnosis with any candor.
“Reveal bad news? Talk about dying? As far back as the Greeks — more than 1,000 years ago — it was thought that revealing a bad diagnosis was bad for the patient and would depress the spirit,” he says. Even in the mid-19th century brutal truths were discouraged.
“What the doctor would do, was take a family member of the patient into his confidence, and tell that relative that the patient’s situation was actually much worse than it seemed,” he says. “That way, if the patient survived, the doctor looked like a hero. If the patient died, the doctor had been smart enough to predict it.”
And today? By and large, Frankel says, today’s doctors, at least those practicing in the US, are no more enlightened than their antecedents. The field of oncology is all about the disease — most trainees get no preparation in how to discuss illness with a patient.
Moreover, Frankel points out: ”In the mind of doctorss death is the ultimate defeat, and they don’t want to admit defeat.”
Next Thursday: Frankel will discuss what patients and their relatives and friends can do to get medical personnel to discuss end of life issues with candor.
