Creating a Healing Relationship Between Patient and Physician
May 30, 2014
2 + 2 will always = 4. But, two people who are dealing with cancer, one a doctor and the other a patient, what do they equal?
A healing relationship is more than just two people. It is about an assumption that at the core of the relationship is the wellbeing of the patient. It creates an expanded wellness and hope factor. It is about trust where there was fear. It is more than simple arithmetic.
While for many years scientific objectivity has ruled the basis for medical science, the lack of understanding of how a person lives through an illness has become more evident in today’s world of trying to optimize the patient experience.
The first mountain to climb is the belief that the “experience” has no medical relevance. The Meaning Response, so well defined by Moerman and Jonas as “the physiologic or psychological effects of meaning in the origins or treatment of illness,” which has been shown to include everything from how the physician looks and acts, the tone of voice during examination, and, of course, the prognosis. Meaning drives health, let alone recovery.
How we perceive our situation and engage with our own recovery absolutely matters. So, why wouldn’t the “how are you, really?” be part of a medical history?
Next, the misinformation found so easily on the Internet is setting up patients to already be engaged, but without the information that really matters. Can direct physician/patient dialogue be fully informative, with complete acknowledgement of the confusion? Like a real medical “fact check?”
Then, and perhaps the most important, is the ongoing empathetic patient-physician dialogue that prioritizes the “check in” before the “check up.” A doctor intently gazing at the computer instead of the patient does not equal or come close to eye-to-eye contact.
“Right now, you matter more than your medical records,” is what eye-to-eye contact says to patients.
A recent meta-analysis funded by the Arnold Gold Foundation found that the patient-clinician relationship affects medical outcomes. The results showed that “general empathy in a meaningful patient-clinician relationship appears to improve patient’s well being, both emotionally, and now, physically.”
Physician burnout can easily be traced to a lack of human connection that has defined the role of the healer long before the crowning of the M.D. removed it. If I am handing my life over to you, doctor, I need to know that the person that I am, my experience of what is happening to me, and the risks as I perceive them matter to YOU.
In her book, Kitchen Table Wisdom: Stories That Heal, Naomi Rachel Remen observes:
“People who are physicians have been trained to believe, that it is a scientific objectivity that makes them most effective in their efforts to understand and resolve the pain that others bring them, and a mental distance that protects them from becoming wounded from this difficult work.”
She goes on to write, “Objectivity, empathy, and global thinking, are not incompatible with a degree of dissociation, sufficient to protect oneself, from the patient’s suffering. This has been my personal experience.”
Suffering, isolation, and defensive detachment plague our society and are most clearly expressed in our healthcare system. The healing of healthcare is critical to healing ourselves, our relationships, and our communities.
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