Research aims at improving communication, compassion between doctor, patient
By Ross Tomlin
Does your doctor give you the cold shoulder instead of a warm welcome? If so, researchers at Baylor College of Medicine in Houston, who are taking a look at the evolution of doctor-patient dynamics and the culture of medical education, hope to explain why.
Doctors today must be more flexible and sensitive than ever and adapt treatment protocol to individual patient needs, according to Paul Haidet, M.D., M.P.H., assistant professor of medicine at BCM and a staff physician at the Michael E. DeBakey Veterans Affairs Medical Center in Houston.
"Doctors are in a difficult position in that their job is much more difficult today than it was in the past," said Haidet. "Increasing numbers of patients are proactive, empowered by the Internet, and want to have partnerships with their doctors."
Communication dynamics
In addition to the advent of the Internet, doctor-patient relations have also been affected by advances in healthcare technology. Developments like electronic medical records streamline medical operations but do not necessarily improve patient care in every case.
"The technology gives doctors extraordinary tools for information management, diagnosis, and therapeutics," said Haidet. "Those tools exist in the context of a relationship between the doctor and a patient. To the extent that that relationship is a good one, the tools are going to enhance that relationship; and to the extent that the relationship is a bad one, the tools are just going to make it that much worse."
According to Haidet, a cultural sea change in medicine must take root in the "hidden curriculum" – the values, attitudes, and professional identities that medical students develop, not through formal instruction but by working in healthcare facilities and observing their mentors' treatment of patients. Haidet and other medical professionals agree that both formal and "hidden" curricula should reinforce the notion that patients must be treated as human beings rather than case studies.
Cultural environments
"Medical school students really need to have life skills about developing relationships, especially where the expectations change from patient to patient," said Haidet. "The setting of illness is one of the most difficult times to be having a relationship because the patient is scared, wants to know what to do, and must cope with the social stress of being sick. Doctors need not only the skills to develop relationships but also to do so in the extraordinarily difficult context of illness."
Haidet is among several researchers currently spearheading research that assesses the cultural environments at different medical schools as a first step in improving communication and compassion between doctor and patient.
"We are deeply interested in ensuring that students not only have the technical skills but also the healing skills to be good doctors," said Haidet. "That's critical for our profession."
