There are forces that subtly (and not so subtly) erode the traditional patient-physician relationship and reduce physician satisfaction. These forces are not all intrinsically bad; many reflect positive technological advances in the battle against disease. Some forces are economic, representing efforts to maintain the financial solvency of a patient’s choice-oriented model of health care. Others actually reflect attempts to preserve our own sense of humanity, a particularly important goal as young physicians mature through professional adolescence (residency training).
But increased reliance on sophisticated imaging and testing techniques can reduce time spent in thoughtful direct patient interaction. Ubiquitous support staff and phlebotomy teams increase efficiency, but reduce the number of opportunity moments for physical contact and discussion between physician and ill patient. Shortened outpatient visits and hospital stays, increased paperwork, enforced limited work hours and more team coverage further diminish face time with our patients. Use of electronic charting reduces chat time and eye contact in the office. And as the patient is progressively moved away from the doctor’s gaze and touch, human aspects of patient care may wither, including the sense of connection between physician and patient. Rewards from interacting with our patients as people become elusive.
As one of many efforts to stem this withering of the joy of patient care and to increase the appreciation of the special role we are permitted to play as physicians, we offer our Medical Humanities Program. The program provides various venues to reflect on our personal practice of medicine and on our profession. We hope these different presentations will encourage reflection upon various aspects of medicine, the patient as person, our growth as physicians and individuals, and about health care delivery in general.
Our aggressive and ongoing pursuit of medical knowledge, efficiency, and financial responsibility easily competes with history, literature, religion, music, poetry, and ethics; the very things that personally enrich us as physicians. As we build research networks and encourage the maturation of physician scientists, we should not ignore introspective aspects of our interactions with patients, and our connections with the past. We should weave the threads of self-assessment and reflective practice into a shawl that we can comfortably wear throughout our professional lives.
Brian F Mandell, MD, PhD, FACP, FACR
Professor and Chairman Department of Medicine
Cleveland Clinic Lerner College of Medicine of CWRU
Center for Vasculitis Care and Research
Editor in Chief, Cleveland Clinic Journal of Medicine