Monday, August 23, 2010

“We are not Dr. God”

Funny...I never thought you were.

Yet last week was the second time in recent years a physician said that to me during a doctor visit. It happens when I start asking questions.

I explained my situation then tried to ask a question. But before I even finished articulating it, the doctor interrupted and started answering based on what he thought I wanted to know. When I tried to refocus the conversation on my particular circumstances, he just continued his spiel with "'We are not Dr. God'" thrown in.

I think his comment reveals an interesting self-perception.

I do not believe physicians are omniscient. But I do expect them to answer my questions. Note: answer my questions, not cure my ailments. If a doctor can explain my symptoms, great! If she can treat or eliminate the problem, even better! But if a physician doesn’t know why my body is acting the way it is, that’s an answer, too. And a straightforward “I don’t know” while perhaps dismaying is at least honest and respectful.

“We are not Dr. God” is a defensive, and demeaning, statement. But maybe it’s our own fault.

In the western world, we groom doctors like thoroughbred horses. In college, premed students are held in awe: “Medicine is hard! You must be smart!” The ego-building and instant prestige continue when proud parents later brag “My daughter, the doctor!” or people add “He’s a doctor!” when parading the specimen at social gatherings. (Sorry, lawyers no longer cut it.)

Never having had to justify their career choice or, since most mere mortals don’t understand medicine, explain their decision-making, it's no surprise that many physicians perceive questions from patients as a challenge to their authority, competence, knowledge, ability – who knows? – and react defensively. Questions break their stride.

Or maybe they’re just nerdy introverts with lousy communication skills.

(Does it matter that I’m female? The doctors who said this to me were male. Would a female physician say this to a female patient, or a female physician to a male patient, or a male physician to a male patient?)

I’m aware there’s a fine line between too little and too much information, and I can imagine many doctors consider talking with patients a no-win situation: If I don’t say much, the patient will complain about being uninformed. If I say too much, the patient will accuse me of information overload or being too technical. That’s why doctors need to listen to patients and hear what they’re saying, and respond accordingly. Health care is a two-way street: It's a dialog, not a monolog.

A physician friend claims the most important skill of a good doctor is an ability to work with people. (What good is knowledge if it doesn’t translate into effective care?) I agree.

Don’t talk at me, talk with me.

See related posts Doctors never make mistakes and Name game.

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