We all have those areas of life where we just feel incredibly out of place and like we are standing like deer in the headlights. For me, this is going to the mechanic. I’m always nervous to bring my car in; what if there is something wrong with my car and I can’t afford it, what if the mechanic tries to pull a fast one on me, what if, what if, what if? I recently had to go to my mechanic, and he proceeded to list all the things wrong with my car. As I stood there nodding my understanding I was really thinking that I had no idea what he was talking about. He was using words I didn’t know, explaining about parts of the car I had never heard of, and the list of my ignorance goes on. Obviously I know nothing about vehicles, but I don’t want him to know that! When he finished and asked if I had any questions I responded confidently, “Nope, you did a great job of explaining that, thank you,” when really I had no idea what to ask because since I only understood maybe 10% of what I was told, forming any question was difficult.
When I think about my interaction with my mechanic, it surprises me how similar this interaction is to the ones that physicians have with their patients. Patients don’t want to go to their doctor, they are worried there will be something wrong with them, they are worried that they will not understand what the doctor is telling them, they are worried about how much they are going to have to pay for medical care. When the doctor explains his or her plan to their patient, often the patient nods and agrees as if they completely understand everything they are being told and when asked if they have questions, nope! They got it all. Just like I can’t come up with any questions for my mechanic, patients can’t ask appropriate questions when they really have no idea about what just happened.
Patients should not have to go to their family physician with the fears I just described. Their physician should be a source of comfort and trust, not fear. One reason I have this view is because the first physician I ever knew and one of the reasons that I wanted to go into medical school was my grandpa. He was a family physician in rural Iowa starting in the 1950s. One thing I always remember him stressing about medicine is that patients are people, not diseases, conditions, or numbers on a list. He cared about the people he served and the relationships with them. His practice flourished because of his view toward his patients, and he was a trusted, revered man to the whole town.
Due to the influences of my grandpa and my medical school experiences I have learned I want to make sure I provide three services to my patients that I believe are lacking in many physician’s offices. First, I want my patients to feel comfortable walking into my office and voicing any worries they may have because they know that nothing will be brushed aside as not important if they believe it is. Second, I want to make sure that none of my patients feel stupid for any question they may have. Finally, I want to help my patients understand all parts of their medical care in terms they understand. These three points are really all related. Working backwards, if medical care is explained in terms that patients can understand, then they will actually be able to formulate questions for their physician without feeling stupid, and this in turn will lead to patients feeling comfortable coming into the office with any worry or concern. To me, this is what family medicine is all about, forming relationships where communication is open so that trust can form and in turn lead to the best possible medical care.
I was excited to see the article “Partnering With Patients, Families, and Communities” in the Family Medicine for America’s Health special issue of the STFM journal, Family Medicine, because I felt it really laid out goals for the direction of family medicine that fit with the ones I have explained above. This article argues that only through meaningful patient engagement built on trust and respect can the health care in our country improve. As stated in the article:
“During this process the patient and family must be encouraged to ask questions and express confusion or lack of understanding. Incumbent upon the provider is the guarantee that transformation occurs. Only through a dynamic exchange between all parties can comprehension be assured.”
I am excited about the work being done by Family Medicine for America’s Health (FMAHealth) mentioned in this article as they strive to “challenge the status quo in collaborative care.” If we can have groups like this in our country with the goal of remembering what family medicine is really about, there truly is some hope for health care in this nation. If physicians can always remember like my grandpa did that patients are people and treat them as such, then true collaboration and trust will occur because as the article says, “Collaborating with patient, families, and communities is a core principle of family medicine.”
In my opinion, this is one place where family medicine can really shine. In an ideal world, all primary care doctors (actually, all doctors period) should seek to foster this dynamic. But in family medicine where the relationship with our patient is the most important thing we have, there can be no excuse for patients who are not well informed about their health, and who feel powerless to ask questions. Well spoken, Dr. Baatenburg – well spoken.
Thank you for taking time to read this and for your kind words. I really appreciate it!