Doctor's Office: A Safe Haven?

Wednesday, 13 Mar 2013 10:07 AM

By Erika Schwartz, M.D.

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Imagine that. Going to the doctor and finding the doctor’ office a refuge, a place of solace from fear and danger. Does that ever happen to you? How many doctors do you know whose offices are a place of calm and kindness? How many doctor’s offices do you look forward to going to? To just sitting in the waiting room for 15 minutes skimming through crisp, new magazines, yes the Wag, and enjoying beautifully appointed walls with artwork that appeals to you and seats that are clean, shiny, and very comfortable?
 
A place where calm and comfort radiates from every corner.
 
How many receptionists and nurses in a doctor’s office can you think of that are lovely, responsive, and supportive of your needs? How often is the conversation about your needs rather than about your insurance and money?
 
And what about the doctor? How many of you can honestly say you are looking forward to seeing your doctor because when you leave his or her office, you feel empowered, fearless, and ready to take on the world and enjoy your life?

Unfortunately, I know the answer to all those questions and all too often they are: “Are you crazy? The doctor’s office and the doctor are a source of intimidation and fear. All they care about is to get me in and out like cattle and send a huge bill. I feel I’m there to pay the doctor’s mortgage.”
 
Isn’t that so totally unfortunate and unnecessary.
 
I’ve been a practicing physician for more than 30 years and I can tell you without a doubt at this point in my career people come to see me from all over the world and invariably tell me they look forward to their visit with me. They also constantly tell me how wonderful our nurse, other doctor, and all our support staff are. I am proud of it and I am not arrogant or obnoxious; anyone who knows me will attest to that. I’m just trying to make a long overdue point.
 
It took many years to get here.
 
When I first started to work in private practice in Irvington in the 1980s, I had left the Emergency Room because I wanted to have a relationship with my patients and make it personal to boot.
 
I wanted to be part of my patients’ lives because even though I was young and not very experienced at life, I felt that knowing my patients personally was going to make me a better doctor. No one had taught me that in medical school; in fact unfortunately for all of us, they still don’t’ teach that there.
 
I just felt that while I was a total hot dog about the science and the most up-to-date ways to treat disease, that information may not apply the same way to every patient.
 
In my gut I knew everyone was different even if on the inside on the operating table we look the same for the most part.
 
So, I thought that making house calls and learning about my patient’s family life would be another helpful part of the healing process.
 
No, I did not have any intention of becoming a psychiatrist, although many still ask if my main approach to medicine today is that of a psychiatrist because my office no longer has examining rooms but holds comfortable armchairs and coffee tables instead.
 
My answer has always been that medicine that splits people up into pieces, organ systems, and surgical options, and separates body and mind could only do harm, and I was not in that business. In fact, the business I am in is doing good and preventing disease — a new business in medicine these days.
 
In time, while I still did physicals and focused a lot on disease and the organs we human beings have inside of us, I started to realize that the better I knew my patients as whole people and the better they knew me, the better they did when it came to my treating their diseases.
 
Was all this transformation accidental?
 
As per my education, unless it is evidence-based (whatever that may mean) and scientifically proven that is works in many people with the same problem (how many individuals are there) in large populations, the information and treatment of one person means nothing and is immediately discarded as quackery. This is the summary of medical science 101.

Well, initially, I did believe our imperfect scientific approach to be true and the only way to practice medicine because I was well brainwashed by the medical education I received and I was afraid I might be wrong to go a divergent route from academic medicine.
 
But nothing works better than the wisdom one accumulates in time, and nothing reinforces a clinician who cares better than watching the individual patient do well.
 
One by one, slowly at the beginning and now all the time, I started to drop my facade that dictated I was a doctor and the patient was a patient.
 
First, I dropped the use of the white coat. I thought it stuffy and there, only to put distance between me and my patients. If I got anything undesirable on my dress I could always have it cleaned.
 
And beside, people knew my name before they came to see me, so why the name tag or the fancy embroidered white coat with my name and title? They certainly don’t provide any hygienic or sterilizing effects.
 
Next, I realized the only way to help was to eliminate the third party in the examining room. By that I mean, no more drug information in my head, no more fear of malpractice, no more insurance company dictating how long we would talk or how I should treat my patients.
 
Finally, I hit pay dirt. I eliminated my ego.
 
If a patient thought I was wrong or came with a bad attitude, I did not take it personally.
 
I am here to help. And most people don’t go to the doctor for fun.
 
They are scared or feel sick. So who am I to tell them how to express themselves or get offended when they ask questions I may not have answers to.
 
In time, with all these obstacles to being a good doctor and serving the patient out of the way, I noticed people becoming happy to see me and happy when leaving the office. Smiles replaced sadness and courage replaced fear.
 
My patients did well and do even better these days.
 
It may be the placebo effect, but we now know scientifically that is a good thing.
 
So many things change from bad to good in our confusing and confused medical world that I feel quite comfortable with the way I practice medicine just because my patients do so well.
 
So come on down. Find a doctor whose office is a safe haven of kindness, support, and yes, love for you. See how much better you will do. And yes, this is all evidence-based medicine I am referring to. The evidence is always based on one. Just one. YOU.
 
 

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