A few years back, I had a medical student sitting in with me during a patient visit; I noticed that he was getting increasingly fidgety. I think I may have detected an overly broadcast exhalation. When I finished a short physical exam and had spoken to the patient about her presenting illness, I brought the student into one of our back rooms. I asked him what was wrong.
He was bursting at the seams with questions that starting to come out at me, rapid fire. Do you spend that much time with every patient? Why did you ask all those questions about her home life & work life and what was with all that silence? Did you really need to spend that much time listening to her lungs?
I answered his questions as best I could, that yes I am lucky I can spend that much time with patients, and yes, I find it essential to build a connection with the person. As importantly, I try to find out as much as I can about the way they uniquely experience the complaints they have. Yes, for me understanding at least some of the stressors that go into making or maintaining health problems is essential and helps me be a better doctor. And periods of silence, sometimes it is in the quiet times that a patient feels most heard and cared for. If I take a little longer with aspects of a physical exam, it's because I want to know that I am being thorough, and I want the patient to feel genuinely cared for.
When I graduated from naturopathic medical school in 1986, my soon to be father-in-law was and still is, at 85, god bless him, a barber. He gave me prime advice that day. He said when the customer (patient) comes in, be leisurely, take your time, let them talk. In the middle of the transaction (cutting the hair, doing the intake) be a bit quicker as long as your skills do not suffer. And then, toward the end of the visit, be sure you go back in to your slower, more connected pace. I shared that with my medical student, let's hope he heard that sage advice!
We are taking time this summer for some R&R, to think about our lives at this 50 year mark & to make plans for the next adventures in & out of the world of medicine! Hope you, too, have time to enjoy, time for reflection and time with those you love.
Dr. Amy Rothenberg, ND
Naturopathic Health Care